前负荷不足时运动时无氧阈值的血流动力学反应。

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL European Journal of Clinical Investigation Pub Date : 2024-11-11 DOI:10.1111/eci.14343
Shoaib Fakhri, Luiz Campedelli, Michael G Risbano
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引用次数: 0

摘要

背景:前负荷不足是有创心肺运动测试中发现的运动不耐受的一个未被充分认识的原因,其血流动力学定义为峰值努力时双心房充盈压、心输出量和耗氧量(VO2)的降低。然而,前负荷功能不全患者通常表现为用力时呼吸困难和/或次最大负荷时运动不耐受的症状,尤其是在进行日常生活活动时。关于前负荷不足的心肺血液动力学和生理机能在亚最大负荷下的表现,以前还没有进行过研究。我们假设,前负荷不足的血流动力学存在一个连续体,亚最大运动值反映了运动心肺血流动力学峰值:我们比较了前负荷功能不全患者与因呼吸困难而转诊但运动反应正常的年龄匹配对照组在无氧阈值下测量的亚最大心肺血流动力学:我们的研究包括 66 名患者:结果:我们的研究包括 66 名患者:41 名前负荷功能不全患者和 25 名对照组患者。与对照组相比,前负荷功能不全患者在亚极限水平的 V̇O2、瓦特数和 METS 均显著降低,同时较早达到无氧阈值,且无氧阈值下的心率相似:这些发现强调了前负荷不足对亚最大运动能力的深远影响,并强调了识别和管理前负荷不足的重要性。这一洞察力为进一步研究针对亚极限运动水平前负荷不足的干预措施,以提高运动表现和生活质量奠定了基础。
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Hemodynamic responses at anaerobic threshold during exercise in preload insufficiency.

Background: Preload insufficiency is an underrecognized cause of exercise intolerance identified during invasive cardiopulmonary exercise testing, and defined hemodynamically by decreased biatrial filling pressures, cardiac output, and oxygen consumption (V̇O2) at peak effort. Patients with preload insufficiency, however, typically present with symptoms of dyspnea on exertion, and/or exercise intolerance at submaximal efforts, particularly when performing activities of daily living. The cardiopulmonary hemodynamics and physiology at submaximal work levels of preload insufficiency have not been previously investigated. We hypothesized that preload insufficiency hemodynamics exist along a continuum, with submaximal exercise values reflecting peak exercise cardiopulmonary hemodynamics.

Methods: We compared submaximal cardiopulmonary hemodynamics, measured at anaerobic threshold, between preload insufficiency patients and age-matched controls referred for dyspnea but with normal exercise responses.

Results: Our study included 66 patients: 41 with preload insufficiency and 25 controls. Preload insufficiency patients exhibit significantly reduced V̇O2, watts, and METS at submaximal levels compared to controls, alongside earlier anaerobic threshold achievement and similar heart rates at anaerobic threshold.

Conclusions: These findings underscore the profound impact of preload insufficiency on submaximal exercise capacity, emphasizing the importance of its recognition and management. This insight sets the stage for further investigations into interventions targeting preload insufficiency at submaximal exercise levels to enhance both exercise performance and quality of life.

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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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