Endothelial function and exercise capacity in patients with chronic heart failure

我们研究了慢性心力衰竭患者外周血管内皮功能障碍的临床意义。慢性心力衰竭患者运动能力与外周血管舒张功能的相关性研究[J]； journal of nurses training; 2009；此外，我们发现瓣膜性心脏病的心脏直视手术后下肢血管扩张储备能力的改善，并发现血管功能的变化与运动能力的变化有显著相关，这是由峰值摄氧量确定的（已提交论文）。这些观察结果表明，内皮依赖性外周血管舒张能力可能在心力衰竭时运动诱导的血管舒张调节中起重要作用。我们还研究了l -精氨酸（内皮源性一氧化氮的底物）对慢性心力衰竭患者下肢外周血管扩张储备和运动能力的影响（n=14）。虽然l -精氨酸输注显著增加了小牛的反应性充血，但运动能力并没有立即改善。这些结果将在一次国际医学会议上提出（第19届欧洲心脏病学会，斯德哥尔摩，1997年）。

We have investigated clinical significance of peripheral endothelial dysfunction in patients with chronic heart failure. There was a significant correlation between exercise capacity and periheral vascular dilatory function determined by acetylcholine administration in patients with chronic heart failure (Am J Cardiol 77 ; 98-102 : 1995). Furthermore, we have found an improvement of lower limb vasodilatory reserve capacity after open heart surgery for valvular heart disease, and found that changes in the vascular function were significantly correlated with changes in exercise capacity as determined by peak oxygen uptake (paper in submission). These observations suggest that endothelium-dependent peripheral vasodilatory capacity may be important in the regulation of exercise-induced vasodilation in heart failure. We have also examined effects of L-arginine (a substrate of endothelium-derived nitric oxide) on lower limb peripheral vasodilatory reserve and exercise capacity in patients with chronic heart failure (n=14). Although reactive hyperemic blood flow in the calf was significantly augmented by L-arginine infusion, exercise capacity did not improve immediately. These results will be presented in an international medical meeting (19th European Society of Cardiology, Stockholm, 1997).