JAHA:大面积和次大面积肺栓塞患者的心肺运动试验!

2018-03-03 xing.T MedSci原创

由此可见,大面积和次大面积肺栓塞的病人中持续性症状、右心室结构和功能的异常以及客观运动受限较为常见。功能障碍似乎是由于一般性失调而不是内在的心肺限制所致,建议运动康复作为改善患者预后和生活质量的重要手段。

关于急性肺栓塞患者功能性运动的资料很少。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员试图描述大、次大面积肺栓塞患者症状负担的自然史、右室(RV)的结构和功能以及运动能力。

研究人员对大、次大面积肺栓塞的幸存者(n=20,年龄为57±13.3岁,8/20为女性)在出院后1个月和6个月时进行临床评估、经胸超声心动图检查和心肺运动试验。

在1个月时,9/20(45%)例患者纽约心功能分级超过II级,13/20(65%)例患者表现出持续性右心室扩张和收缩功能障碍,以及14/20(70%)例患者存在客观的运动障碍,通过峰值耗氧量(vO2)小于性别年龄预测最大值(16.25 [13.4–20.98]ml/kg/min)的80%来定义。在6个月时,症状严重程度、RV的结构和功能以及vO2(17.45 [14.08–22.48] ml/kg/min,P = NS)无明显改善。没有患者表现出运动受限是由于右肺血管耦合所致,定义为VE/VCO2斜率>33,或在任何时间点的肺机械性运动受限。同样,持续性右心室扩张和功能障碍与任一时间点的症状负担或峰值vO2无显著相关性。

由此可见,大面积和次大面积肺栓塞的病人中持续性症状、右心室结构和功能的异常以及客观运动受限较为常见。功能障碍似乎是由于一般性失调而不是内在的心肺限制所致,建议运动康复作为改善患者预后和生活质量的重要手段。

原始出处:

Mazen S. Albaghdadi,et al. Cardiopulmonary Exercise Testing in Patients Following Massive and Submassive Pulmonary Embolism.JAHA.2018. https://doi.org/10.1161/JAHA.117.006841

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    2018-10-10 aids222
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channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:21 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
  5. 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  6. 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    2018-03-11 xiaotao112411

    学习学习学习

    0

  7. 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    2018-03-11 xiaotao112411

    学习学习学习

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  8. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:39 CST 2018, time=2018-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295051, encodeId=4a0729505129, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:34 CST 2018, time=2018-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295050, encodeId=9e59295050ac, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:30 CST 2018, time=2018-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295049, encodeId=e3352950491b, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:26 CST 2018, time=2018-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295048, encodeId=bad2295048bf, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:21 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
    2018-03-11 xiaotao112411

    学习学习学习

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  9. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:39 CST 2018, time=2018-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295051, encodeId=4a0729505129, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:34 CST 2018, time=2018-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295050, encodeId=9e59295050ac, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, 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channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Sun Mar 11 06:14:21 CST 2018, time=2018-03-11, status=1, ipAttribution=)]
    2018-03-11 xiaotao112411

    学习学习学习

    0

  10. 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    2018-03-11 xiaotao112411

    学习学习学习

    0