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Blood Pressure Control During Exercise in Heart Failure

心力衰竭运动期间的血压控制

基本信息

批准号：
7915291
负责人：
Donal S O'Leary
金额：
$ 38万
依托单位：
WAYNE STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
1996
资助国家：
美国
起止时间：
1996-07-08 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7915291
关键词：
Acute Address Affect Age American Anesthesia procedures Animals Area Arts Baroreflex Blood Pressure Blood Vessels Blood Volume Blood flow Buffers Canis familiaris Cardiac Cardiac Output Cardiovascular Physiology Cardiovascular system Catecholamines Cause of Death Chronic Complex Congestive Heart Failure Conscious Consumption Coronary Coronary Circulation Denervation Diagnosis Excision Exercise Exercise Tolerance Face Functional disorder Funding Goals Health Heart Heart Rate Heart failure Hindlimb Homeostasis Hormones Hospitals Incidence Individual Investigation Ischemia Kidney Laboratories Left Measurement Mediating Metabolic Minority Modeling Moderate Exercise Monitor Muscle Myocardial Nerve Neurons Newly Diagnosed Operative Surgical Procedures Patients Peripheral Plasma Population Pressoreceptors Pump Reflex action Resistance Rest Role Skeletal Muscle Strenuous Exercise Sympathetic Nervous System Symptoms Time Trauma Treatment Cost United States United States National Institutes of Health Vasodilation Ventricular Ventricular Arrhythmia Ventricular Dysfunction Ventricular Function blood pressure regulation constriction design exhaust hemodynamics improved indexing innovation instrument instrumentation muscle form neuroregulation pressure prevent research study response restraint sudden cardiac death vascular bed vasoconstriction

项目摘要

Over 5 million Americans suffer from heart failure with over a half a million newly diagnosed cases each year. The annual cost of treatment is approaching 40 billion dollars with over 20 billion dollars in hospital expenses alone. The incidence of heart failure increases with age and is markedly higher amongst minority populations. Therefore, heart failure presents a major health problem in the United States as well as worldwide. Exercise intolerance is a classic symptom of heart failure. Even moderate exercise may leave the patient exhausted and out of breath. In this setting often extreme activation of the sympathetic nervous system occurs causing profound peripheral vasoconstriction. Even the coronary vasculature may be vasoconstricted causing local ischemia and increased incidence of ventricular arrhythmias and sudden cardiac death. The mechanisms mediating this exaggerated activation of the sympathetic nervous system during exercise in subjects with heart failure are poorly understood. Previous studies have implicated abnormal activation of the muscle metaboreflex in mediating these responses. This competing renewal proposal is focused on expanding our investigations of altered neural control of cardiovascular function during exercise in heart failure. We will utilize our innovative and highly complex conscious, chronically instrumented canine model. Our long term goal is to further elucidate the mechanisms responsible for the heightened activation of the sympathetic nervous system during exercise in heart failure and the functional consequences of these responses in the integrative control of cardiovascular function. This proposal is focused on the altered neuronal control of coronary blood flow and the impact on ventricular function during exercise in heart failure. A major strength of the proposal is our unique capability of simultaneous measurement of a number of critical central and peripheral hemodynamic parameters in real time at rest and during exercise in the same animals before and after induction of heart failure. These longitudinally designed experiments we feel will provide compelling new information on the altered mechanisms of cardiovascular control during exercise in heart failure.

超过500万美国人患有心力衰竭，每年有超过50万新诊断病例。每年的治疗费用接近400亿美元，仅医院费用就超过200亿美元。心力衰竭的发病率随着年龄的增长而增加，在少数民族人群中明显更高。因此，心力衰竭在美国乃至全世界都是一个主要的健康问题。运动不耐受是心力衰竭的典型症状。即使是适度的运动也可能使病人精疲力竭，上气不接下气。在这种情况下，交感神经系统的极端激活经常发生，引起严重的周围血管收缩。甚至冠状动脉血管也可能收缩，引起局部缺血，增加室性心律失常和心源性猝死的发生率。在心力衰竭患者运动过程中，交感神经系统过度激活的机制尚不清楚。先前的研究表明，肌肉代谢反射的异常激活介导了这些反应。这一竞争性更新建议的重点是扩大我们对心力衰竭患者运动期间心血管功能神经控制改变的研究。我们将利用我们的创新和高度复杂的意识，长期仪器犬模型。我们的长期目标是进一步阐明在心力衰竭运动中交感神经系统激活增强的机制，以及这些反应在心血管功能综合控制中的功能后果。这一建议的重点是改变神经元控制冠状动脉血流和心室功能在心力衰竭运动期间的影响。该建议的一个主要优势是我们在诱导心力衰竭之前和之后的同一动物中，在休息和运动期间实时测量一些关键的中央和外周血液动力学参数的独特能力。我们认为这些纵向设计的实验将为心力衰竭患者在运动过程中心血管控制的改变机制提供令人信服的新信息。