EFFECT OF POSTURAL CHANGE IN HEART TRANSPLANT PATIENTS

体位改变对心脏移植患者的影响

• 批准号: 3027837
• 负责人: Lynn Valerie Doering
• 金额: $ 1.28万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-10-23 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3027837
• 关键词: autonomic reflex; blood pressure; cardiac output; denervation; electrocardiography; environmental adaptation; heart rate; heart transplantation; hemodynamics; human subject; intracardiac volume; norepinephrine; posture; vascular resistance

A consequence of orthotopic heart transplantation is permanent denervation of the donor heart. The specific aim of the proposed study, "The Effect of Orthostatic Change on Cardiovascular Stability in Orthotopic Heart Transplant Recipients" is to compare changes in cardiac output (CO), stroke volume (SV), mean arterial pressure (MAP), heart rate (HR), systemic vascular resistance (SVR), and norepinephrine (NE) levels in heart transplant recipients and in normal subjects when both are subjected to a tilt table test. The long-term objectives include determining how physiologic responses are altered when autonomic function is disrupted by cardiac denervation. Using a two-group, quasi-experimental pretest- posttest design, heart transplant recipients and age- and sex-matched normal controls will be subjected to passive tilt from horizontal to 70 degrees via a motorized tilt table. Exclusion criteria for transplant subjects include: evidence of cardiac or renal failure, fluid retention, dizziness, syncope, or orthostatic hypotension. Exclusion criteria for control subjects include: orthostatic hypotension, syncope, palpitations or any other manifestation of cardiac or endocrine dysfunction. Repeated measures of CO, SV, MAP, HR, SVR, and NE levels will be taken before, during, and after passive tilt. Data will be analyzed using repeated measures multivariate analysis of variance. Understanding how physiologic responses are altered when autonomic function is disrupted will enhance nurses' abilities to provide effective care and to promote independent activity among heart transplant recipients.

原位心脏移植的后果是永久性去神经支配 捐赠者的心脏。 拟议研究的具体目标是“ 原位心脏心血管稳定性的直立性变化 移植受者”旨在比较心输出量（CO）、中风的变化 容量 (SV)、平均动脉压 (MAP)、心率 (HR)、全身 心脏血管阻力 (SVR) 和去甲肾上腺素 (NE) 水平 移植受者和正常受试者，当两者都受到 倾斜台测试。 长期目标包括确定如何 当自主神经功能受到干扰时，生理反应就会改变 心脏去神经支配。 使用两组准实验预测试 后测设计、心脏移植受者以及年龄和性别匹配 正常控件将受到从水平到 70 度的被动倾斜 通过电动倾斜台进行度数测量。 移植的排除标准 主题包括：心脏或肾衰竭的证据、液体潴留、 头晕、晕厥或体位性低血压。 排除标准 对照受试者包括：直立性低血压、晕厥、心悸 或心脏或内分泌功能障碍的任何其他表现。 重复 之前将测量 CO、SV、MAP、HR、SVR 和 NE 水平， 被动倾斜期间和之后。 将使用重复分析数据 测量多变量方差分析。 了解生理学如何 当自主神经功能被破坏时，反应会改变，会增强 护士提供有效护理和促进独立的能力 心脏移植受者之间的活动。