Adaptacion hemodinamica al ejercicio de intensidad creciente en el bronquitico cronico

Romero Colomer, P.; Schrijen, F.

doi:10.1016/S0300-2896(15)32490-X

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En 21 enfermos, bronquíticos crónicos, ha sido estudiada la hemodinámica cardio-pulmonar en reposo y en el curso de varios niveles de ejercicio. Los enfermos fueron divididos en tres grupos según la existencia y tipo de hipertensión arterial pulmonar (HAP), a saber: sujetos normotensos (grupo A), sujetos hipertensos al ejercicio moderado (grupo B) y sujetos con HAP de reposo (grupo C). Las principales características diferenciales concernientes a la adaptación hemodinámica al ejercicio se observaron entre los grupos A y C caracterizándose por un comportamiento del lecho vascular pulmonar «más rígido» en el grupo C, así como un mayor recurso a la frecuencia cardíaca con limitación de la adaptación del volumen sistólico en este grupo. La significativamente mayor frecuencia de elevaciones anormales de la presión bloqueada durante el ejercicio en el grupo C permite sospechar una alteración de la mecánica cardíaca biventricular durante el ejercicio, en relación a la elevación del volumen sistólico, hipótesis que se discute.

Summary

For 21 patients suffering from chronic bronchitis the authors have studied cardio-pulmonary hemodynamics at rest and during the course of various levéis of exercise. The patients were divided into three groups according to the existence and type of pulmonary arterial hypertension, namely, subjects with normal tensión (group A), subjects with hypertension to modérate exercise (group B), and subject with pulmonary arterial hypertension at rest (group C). The principal differential characteristics concerning the hemodynamic adaptation to exercise was observed between groups A and C and was characterized by a «more rigid» behaviour of the pulmonary vascular bed in Group C, as well as greater recourse to cardiac frequency with limitation of the adaptation of the systolic volume in this group. The significantly greater frequency of abnormal elevations of the blocked pressure during exercise in group C permits one to suspect an alteration of biventricular cardiac mechanics during exercise, in relation to the elevation of the systolic volume. This hypothesis is discussed.

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*

Trabajo incluido en la Tesis Doctoral presentada en la Universidad de Valencia bajo el título: «Fisiopatología del ejercicio muscular en el Bronquítico Crónico

**

Dirección Actual: Ciudad Sanitaria Príncipes de España. Servicio de Aparato Respiratorio. Sección de Fisiopatología Respiratoria. Hospitalet de Llobregat. Barcelona

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