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首页> 外文期刊>American Journal of Physiology >Renal blood flow in heart failure patients during exercise.
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Renal blood flow in heart failure patients during exercise.

机译：运动期间心力衰竭患者的肾血流量。

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During exercise, reflex renal vasoconstriction maintains blood pressure and helps in redistributing blood flow to the contracting muscle. Exercise intolerance in heart failure (HF) is thought to involve diminished perfusion in active muscle. We studied the temporal relationship between static handgrip (HG) and renal blood flow velocity (RBV; duplex ultrasound) in 10 HF and in 9 matched controls during 3 muscle contraction paradigms. Fatiguing HG (protocol 1) at 40% of maximum voluntary contraction led to a greater reduction in RBV in HF compared with controls (group main effect: P <0.05). The reduction in RBV early in HG tended to be more prominent during the early phases of protocol 1. Similar RBV was observed in the two groups during post-HG circulatory arrest (isolating muscle metaboreflex). Short bouts (15 s) of HG at graded intensities (protocol 2; engages muscle mechanoreflex and/or central command) led to greater reductions in RBV in HF than controls (P <0.03). Protocol 3, voluntary and involuntary biceps contraction (eliminates central command), led to similar increases in renal vasoconstriction in HF (n=4). Greater reductions in RBV were found in HF than in controls during the early phases of exercise. This effect was not likely due to a metaboreflex or central command. Thus our data suggest that muscle mechanoreflex activity is enhanced in HF and serves to vigorously vasoconstrict the kidney. We believe this compensatory mechanism helps preserve blood flow to exercising muscle in HF.
机译：运动期间，反射性肾血管收缩可维持血压，并有助于将血流重新分配到收缩的肌肉。心力衰竭（HF）的运动不耐症被认为与活跃肌肉的灌注减少有关。我们研究了在3个肌肉收缩范例中，在10 HF和9个匹配的对照组中，静态手柄（HG）和肾血流速度（RBV;双工超声）之间的时间关系。与对照组相比，使最大自愿收缩量高40％的HG（方案1）疲劳可使HF的RBV降低更大（组主要影响：P <0.05）。在方案1的早期阶段，HG早期RBV的降低往往更为明显。在HG循环停止后（隔离肌肉代谢反射），两组中观察到了相似的RBV。在梯度强度（协议2;参与肌肉机械反射和/或中枢命令）下，短时间的HG发作（15 s）导致HF的RBV下降比对照组更大（P <0.03）。方案3，自愿性和非自愿性二头肌收缩（消除中央命令）导致HF的肾血管收缩类似增加（n = 4）。在运动的早期阶段，发现HF患者的RBV降低幅度大于对照组。由于代谢反射或中央指令，这种效果不太可能。因此，我们的数据表明，肌肉机械反射活性在HF中得到增强，并且可以使血管收缩。我们认为这种补偿机制有助于保持血液流向HF中的肌肉运动。

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