TREATMENT OF HEART FAILURE IN OLDER HUMANS

老年人心力衰竭的治疗

• 批准号: 6267463
• 负责人: Mark A Supiano
• 金额: $ 11.18万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-01 至 1999-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6267463
• 关键词: behavioral /social science research tag; beta adrenergic agent; beta adrenergic receptor; blood pressure; cardiovascular stress test; clinical trials; congestive heart failure; dosage; electrocardiography; functional ability; heart contraction; heart disorder chemotherapy; heart pharmacology; heart rate; human old age (65+); human subject; human therapy evaluation; isoproterenol; myocardium; neurotransmitter metabolism; norepinephrine; outcomes research; oxygen consumption; physical fitness; prognosis; quality of life; sympathetic nervous system

This proposal will identify the extent to which a medical intervention, therapy with a beta-adrenergic receptor antagonist, will enhance the functional independence of older humans with congestive heart failure (CHF). In addition, the effect of this intervention to modify sympathetic nervous system (SNS) function will be tested as a pathophysiologic mechanism which may contribute to the response to treatment. The initial step in this intervention development study will be to define the range of physiologic characteristics of SNS function in this population relative to older humans with normal myocardial systolic function. The first hypothesis to be tested is that compared to older humans with normal myocardial contractility, older humans with impaired myocardial contractility have a disproportionate increase in SNS activity in comparison to their reduction in beta-adrenergic receptor responsiveness. Two specific aims pertain to this hypothesis: Specific Aim 1: To characterize SNS function, the level of systemic SNS activity (SNSa) using compartmental analysis of 3/H-norepinephrine kinetics and cardiac and peripheral beta-adrenergic receptor function, in older humans with normal and impaired myocardial contractility. Specific Aim 2: To determine the association between myocardial contractile dysfunction and SNS function (e.g. level of SNSa and beta-adrenergic receptor responsiveness), functional measures of disability (e.g. VO/2max and treadmill exercise tolerance), and quality of life in older humans. The hypothesis to be tested in the intervention component of the proposal is the degree to which beta-adrenergic antagonist therapy suppresses SNS activity will predict the extent of improvements in myocardial contractile responsiveness and functional measures of disability and quality of life among older patients with impaired myocardial contractility. The related specific aim states: Specific Aim 3: To determine the effects of beta- antagonist therapy on myocardial contractility, SNS activity (SNSa), beta- receptor responsiveness, functional measures of disability and quality of life in older humans with myocardial dysfunction. The studies outlined in this proposal will determine the effect of beta- adrenergic antagonist therapy on physical performance, functional ability and quality of life in older humans with CHF. In addition, the pathophysiology which contributes to the response to treatment with respect to the role of SNS function in regulating myocardial contractility will also be determined.

该提案将确定医疗干预的程度， β-肾上腺素能受体拮抗剂治疗将增强 患有充血性心力衰竭的老年人的功能独立性 （瑞士法郎）。 此外，这种干预对改变交感神经的影响 神经系统（SNS）功能将作为病理生理学进行测试 可能有助于治疗反应的机制。 最初的 这项干预发展研究的步骤将是确定以下范围： 该人群 SNS 功能的生理特征相对于 心肌收缩功能正常的老年人。 第一个 要检验的假设是，与正常的老年人相比 心肌收缩力，心肌受损的老年人 收缩性使 SNS 活动不成比例地增加 与β-肾上腺素能受体反应性的降低进行比较。 该假设有两个具体目标： 具体目标 1： 使用 SNS 功能、系统性 SNS 活动水平 (SNSa) 来表征 3/H-去甲肾上腺素动力学和心脏和心脏的区室分析 外周β-肾上腺素能受体功能，在老年人中正常 以及心肌收缩力受损。 具体目标 2：确定 心肌收缩功能障碍与SNS功能的关系 （例如 SNSa 水平和 β-肾上腺素能受体反应性）， 残疾的功能测量（例如 VO/2max 和跑步机锻炼 耐受性）和老年人的生活质量。 提案干预部分要检验的假设 β-肾上腺素能拮抗剂疗法抑制 SNS 的程度 活动将预测心肌收缩力的改善程度 残疾和生活质量的反应性和功能测量 心肌收缩力受损的老年患者。 相关的 具体目标说明： 具体目标 3：确定 beta- 的影响 对心肌收缩力、SNS 活性 (SNSa)、β- 的拮抗剂治疗 受体反应性、残疾的功能测量和质量 患有心肌功能障碍的老年人的生活。 本提案中概述的研究将确定 beta- 的效果 肾上腺素能拮抗剂治疗对身体表现、功能能力的影响 以及患有 CHF 的老年人的生活质量。 此外， 病理生理学有助于对治疗的反应 SNS功能在调节心肌收缩力中的作用 也将被确定。