AIRWAYS OBSTRUCTION AND EXECISE CAPACITY IN HEART DISEASE

心脏病中的气道阻塞和运动能力

• 批准号: 3899261
• 负责人: R CANNON
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3899261
• 关键词: angiography; coronary disorder; dyspneas; exercise; heart disorder; oxygen consumption; radionuclide diagnosis; respiratory airflow disorder

Effort dyspnea is common in patients with heart disease and is generally considered to be due to left ventricular systolic or diastolic dysfunction. To investigate a possible contribution of airways obstruction, maximum oxygen consumption was measured during, and peak expiratory flow rate measured before and immediately following treadmill exercise in 25 patients with coronary artery disease, 39 patients with microvascular dysfunction (microvascular angina) and 17 normal controls, all non-smokers. Rest and exercise ejection fraction was measured in patients by radionuclide angiography. Compared to normal volunteers, both men and women with microvascular angina and coronary artery disease had reduced maximum oxygen consumption during exercise. In women, the exercise peak expiratory flow rate was also significantly less than men, demonstrating an actual fall in peak expiratory flow rate compared to that measured at rest. The maximum oxygen consumption correlated with peak expiratory flow rate during exercise for both men and women, but did not correlate with the change in ejection fraction. Thus increased airways resistance independent of left ventricular systolic function contributes to exercise limitation in many patients with heart disease, particularly women. This may result from pulmonary congestion as a consequence of diastolic dysfunction. However, the data are also compatible with reflex bronchial changes during exercise, a phenomenon not seen in normal controls.

劳力性呼吸困难在心脏病患者中很常见， 被认为是由于左心室收缩或舒张功能障碍。 为了研究气道阻塞的可能贡献，最大 在呼气峰流速和呼气峰流速期间测量氧耗量 在25名患者进行跑步机运动之前和之后立即测量 39例微血管功能障碍患者 （微血管性心绞痛）和17名正常对照，所有非吸烟者。休息和 用放射性核素测定患者的运动射血分数 动脉造影与正常志愿者相比， 微血管性心绞痛和冠状动脉疾病患者的最大氧含量降低 运动时的消耗。在女性中，运动时呼气流量峰值 率也明显低于男子，表明实际下降， 与静息时测量的呼气流速峰值相比。最大 氧耗量与呼气峰流速相关， 男性和女性的运动，但没有相关的变化， 射血分数因此，增加气道阻力独立于左 心室收缩功能有助于许多运动限制 心脏病患者，尤其是女性。这可能是由于 舒张功能障碍导致的肺充血。然而，在这方面， 这些数据也与运动期间的反射性支气管变化相一致， 这种现象在正常对照组中是看不到的。