轻度高血压老年患者的运动状态氧脉与静息状态左室收缩和舒张功能相关  

Oxygen pulse during exercise is related to resting systolic and diastolic left ventricular function in older persons with mild hypertension

作　　者：Lim J.G McAveney T.J Fleg J.L. K.J.Stewart 宁宁 

机构地区：[1]Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, United States,Dr.

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2006年第5期19-20,共2页

摘　　要：Background: The mechanisms responsible for impaired cardiovascular hemodynamics during exercise among persons with milder forms of hypertension are not well documented. We examined the relationship of oxygen pulse during exercise, a correlate of stroke volume, with echocardiographic indices of resting left ventricular function to determine whether abnormal contractility and relaxation are related to abnormal cardiovascular dynamics during exercise among such persons. Methods: Subjects were 44 men and 55 women ages 55 to 75 years with mild hypertension but who were otherwise healthy. Resting left ventricular systolic and diastolic functions were assessed with 2-dimensional Doppler echocardiography and tissue Doppler imaging. Oxygen pulse(millimeters per beat)at rest and during multistage treadmill testing was derived from measurements of oxygen consumption and heart rate. The slope of oxygen pulse between successive exercise stages was calculated. Results: After a steep rise in oxygen pulse from rest to stage 1 of exercise, a markedly diminished oxygen pulse slope was seen between subsequent exercise stages. In stepwise regression analysis, the increase in the slope of oxygen pulse from rest to stage 1 was explained by a greater lean body mass(57% , P< .001)and a larger left atrial size(2% , P< .001). After exercise stage 1, the increase in the slope of oxygen pulse was explained by sex(24% , P< .001), higher mitral E/A ratio(6% , P< .001), and higher mitral annular systolic velocity(6% , P< .001). Conclusions: These results suggest that a blunted oxygen pulse response to exercise among older persons with milder forms of hypertension may reflect impaired left ventricular stroke volume changes during exercise secondary to subtle abnormalities in both systolic and diastolic left ventricular functions.Background： The mechanisms responsible for impaired cardiovascular hemodynamics during exercise among persons with milder forms of hypertension are not well documented. We examined the relationship of oxygen pulse during exercise, a correlate of stroke volume, with echocardiographic indices of resting ieft ventricular function to determine whether abnormal contractility and relaxation are related to abnormal cardiovascular dynamics during exercise among such persons. Methods： Subjects were 44 men and 55 women ages 55 to 75 years with mild hypertension but who were otherwise healthy. Resting left ventricular systolic and diastolic functions were assessed with 2-dimensional Doppler echocardiography and tissue Doppler imaging. Oxygen pulse（millimeters per beat） at rest and during multistage treadmill testing was derived from measurements of oxygen consumption and heart rate. The slope of oxygen pulse between successive exercise stages was calculated.

关 键 词：轻度高血压 静息状态 运动状态 左室收缩 老年患者 舒张异常 耗氧量 二维多普勒超声心动图 功能相关 组织多普勒成像 

分 类 号：R544.1[医药卫生—心血管疾病] R443.8[医药卫生—内科学]