Marked sympathetic activation in patients with chronic respiratory failure

被引:208
作者
Heindl, S
Lehnert, M
Criée, CP
Hasenfuss, G
Andreas, S [1 ]
机构
[1] Univ Gottingen, Abt Kardiol & Pneumol, Dept Cardiol & Pneumol, Robert Koch Str 40, D-37075 Gottingen, Germany
[2] Med Univ Lubeck, Dept Internal Med 1, D-23538 Lubeck, Germany
[3] Hosp Gottingen Weende Lenglern, Dept Pneumol, Gottingen, Germany
关键词
autonomic nervous system; respiration failure; microneurography; oxygen;
D O I
10.1164/ajrccm.164.4.2007085
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The autonomic nervous system may be disturbed in chronic respiratory failure. We tested the hypothesis that there is increased sympathetic activity in patients with chronic hypoxemia. Furthermore, we examined the effect of short-term oxygen on muscle sympathetic nerve activity (MSNA) in these patients. We performed microneurography of the peroneal nerve in 11 patients with hypoxemia due to chronic obstructive pulmonary disease (COPD, n = 6) or lung fibrosis (n = 5) and in 11 healthy subjects matched for age and sex. MSNA was measured during normal breathing in all subjects. In eight patients and in seven control subjects, MSNA was also measured during nasal oxygen (4 L/min). MSNA was higher in the patients with chronic respiratory failure compared with the healthy subjects during normal breathing (61 +/- 5 versus 34 +/- 2 bursts/min, mean +/- SEM; p = 0.0002, paired t test). During oxygen administration, MSNA decreased from 63 +/- 6 to 56 +/- 6 bursts/min in the patients (p = 0.0004, ANOVA); there was no change in sympathetic activity in the control subjects. For the first time, there is direct evidence of marked sympathetic activation in patients with chronic respiratory failure. This is partly explained by arterial chemoreflex activation and may play an important role in the pathogenesis of the disease.
引用
收藏
页码:597 / 601
页数:5
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