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首页> 外文期刊>Journal of cardiovascular magnetic resonance : >Reduced peripheral arterial blood flow with preserved cardiac output during submaximal bicycle exercise in elderly heart failure
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Reduced peripheral arterial blood flow with preserved cardiac output during submaximal bicycle exercise in elderly heart failure

机译：在老年人心力衰竭中进行次最大程度的自行车运动时，外周动脉血流量减少且心输出量得以保持

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BackgroundOlder heart failure (HF) patients exhibit exercise intolerance during activities of daily living. We hypothesized that reduced lower extremity blood flow (LBF) due to reduced forward cardiac output would contribute to submaximal exercise intolerance in older HF patients.Methods and ResultsTwelve HF patients both with preserved and reduced left ventricular ejection fraction (LVEF) (aged 68 ± 10 years) without large (aorta) or medium sized (iliac or femoral artery) vessel atherosclerosis, and 13 age and gender matched healthy volunteers underwent a sophisticated battery of assessments including a) peak exercise oxygen consumption (peak VO2), b) physical function, c) cardiovascular magnetic resonance (CMR) submaximal exercise measures of aortic and femoral arterial blood flow, and d) determination of thigh muscle area. Peak VO2 was reduced in HF subjects (14 ± 3 ml/kg/min) compared to healthy elderly subjects (20 ± 6 ml/kg/min) (p = 0.01). Four-meter walk speed was 1.35 ± 0.24 m/sec in healthy elderly verses 0.98 ± 0.15 m/sec in HF subjects (p < 0.001). After submaximal exercise, the change in superficial femoral LBF was reduced in HF participants (79 ± 92 ml/min) compared to healthy elderly (222 ± 108 ml/min; p = 0.002). This occurred even though submaximal stress-induced measures of the flow in the descending aorta (5.0 ± 1.2 vs. 5.1 ± 1.3 L/min; p = 0.87), and the stress-resting baseline difference in aortic flow (1.6 ± 0.8 vs. 1.7 ± 0.8 L/min; p = 0.75) were similar between the 2 groups. Importantly, the difference in submaximal exercise induced superficial femoral LBF between the 2 groups persisted after accounting for age, gender, body surface area, LVEF, and thigh muscle area (p ≤ 0.03).ConclusionDuring CMR submaximal bike exercise in the elderly with heart failure, mechanisms other than low cardiac output are responsible for reduced lower extremity blood flow.
机译：背景老年心力衰竭（HF）患者在日常生活中表现出运动不耐力。我们假设由于前向心输出量减少而导致下肢血流量（LBF）降低将导致老年HF患者的运动耐受力亚差最大。方法和结果12例左室射血分数（LVEF）保持并降低的HF患者（年龄68±10）年）无大（主动脉）或中型（ilia动脉或股动脉）血管粥样硬化，并且13位年龄和性别相匹配的健康志愿者接受了一系列复杂的评估，包括a）峰值运动耗氧量（峰值VO2），b）身体机能， c）主动脉和股动脉血流的心血管磁共振（CMR）次最大运动量度，以及d）大腿肌肉面积的确定。与健康的老年受试者（20±6 ml / kg / min）相比，HF受试者的VO2峰值降低（14±3 ml / kg / min）（p = 0.01）。健康老人的四米步行速度为1.35±0.24 m / sec，而HF受试者为0.98±0.15 m / sec（p <0.001）。进行次最大量运动后，与健康老年人（222±108 ml / min; p = 0.002）相比，HF参与者的股浅浅表LBF的变化减少了（79±92 ml / min）。即使降主动脉血流的应力诱导测量值达到最大（5.0±1.2 vs. 5.1±1.3 L / min; p = 0.87），主动脉血流中的静息基线差异（1.6±0.8 vs. 0.8），也会发生这种情况。两组之间1.7±0.8 L / min; p = 0.75）相似。重要的是，考虑到年龄，性别，体表面积，LVEF和大腿肌肉面积（p≤0.03）之后，两组的次最大运动诱发的股浅浅表LBF的差异仍然存在（p≤0.03）。 ，除了低心输出量以外，其他机制也导致下肢血流量减少。

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