简介:引起唐氏综合征(DS)的遗传疾病会影响心肺和血液动力学参数。锻炼时,活动的肌肉必须有足够的血流量。心输出量(Q)必须与外周需求成比例。如果冲程容积(SV)较低,心率(HR)将进一步增加,以维持活动区域中的足够血流(HR代偿反应)。DS患者对最大运动的HR反应较低。然而,在最大运动的次最大阶段,血液动力学和心肺参数的反应没有得到很好的研究。目的:评估有和没有DS的个体的次最大和2)最大代谢跑步机试验中的心肺和血液动力学参数。方法:15名DS成人(年龄=27.33±4.98岁;n=12男/3女)和15名无残疾成人,年龄和性别相匹配,参加了这项横断面研究。在跑步机测试期间测量峰值和次最大心肺和血液动力学参数。线性混合效应模型用于分析变量之间的相互作用。事后分析用于评估组内和组间差异。结果:DS组通气峰值(VE)较低,呼吸交换比(RER),潮气量(VT),O2的通气当量(VEqO2),O2的潮气末分压(PETO2),O2吸收(VO2)和CO2产生(所有p<0.050),Q,SV,收缩压和舒张压(SBP,DBP),和HR(所有p<0.050)。对于所有通气亚最大值,存在逐组时间相互作用(所有p<0.050)。观察到VE、RER、呼吸频率(RR)、VEqO2、PETO2、VO2和VT的组别和时间差异显著(均p<0.050)。SBP也有不同时间的组相互作用(所有p<0.050)以及组和时间差异,平均动脉血压(MAP)和HR(均p<0.010)。结论:在亚最大运动期间,我们验证了HR的补偿性反应,DS患者的VE和VO2更高。此外,我们能够观察到DS组对亚最大运动的SBP和MAP反应降低.另一方面,我们发现患有DS的成年人具有较低的峰值血流动力学和心肺值,和较低的心脏储备。有必要进行进一步的研究,以研究这些结果对DS成年人的总体健康以及长期锻炼计划对这些参数的影响。
Introduction: The genetic disorder causing Down syndrome (DS) affects the cardiorespiratory and hemodynamic parameters. When exercising, sufficient blood flow is necessary for active muscles. Cardiac output (Q) must be proportional to the peripheral requirements. In case the stroke volume (SV) is lower, the heart rate (HR) will increase further in order to maintain an adequate blood flow in the active territories (HR compensatory response). People with DS have a lower HR response to maximal exercise. Nevertheless, the response of the hemodynamic and cardiorespiratory parameters during the submaximal phases of maximal exercise was not well studied. Objective: to evaluate cardiorespiratory and hemodynamic parameters 1) during submaximal and 2) maximal metabolic treadmill test in individuals with and without DS. Methods: fifteen adults with DS (age = 27.33 ± 4.98 years old; n = 12 males/3 females) and 15 adults without disabilities, matched by age and sex, participated in this cross-sectional study. Peak and submaximal cardiorespiratory and hemodynamic parameters were measured during a treadmill test. Linear mixed-effects models were used to analyse interactions between the variables. Post-hoc analyses were employed to assess within and between-group differences. Results: The DS group showed lower peak values for ventilation (VE), respiratory exchange ratio (RER), tidal volume (VT), ventilatory equivalent for O2 (VEqO2), end-tidal partial pressure for O2 (PETO2), O2 uptake (VO2) and CO2 production (all p < 0 .050), Q, SV, systolic and diastolic blood pressure (SBP, DBP), and HR (all p < 0 .050). There were group-by-time interactions (all p < 0 .050) for all ventilatory submaximal values. Significant group and time differences were observed for VE; RER; respiratory rate (RR); VEqO2; PETO2; VO2, and VT (all p < 0 .050). There were also group-by-time interactions (all p < 0 .050) and group and time differences for SBP, mean arterial blood pressure (MAP) and HR (all p < 0.010). Conclusion: During submaximal exercise, we verified a compensatory response of HR, and greater VE and VO2 in the individuals with DS. In addition, we were able to observe that the DS group had a reduced SBP and MAP response to submaximal exercise. On the other hand, we found that adults with DS have lower peak hemodynamic and cardiorespiratory values, and a lower cardiac reserve. Further research is warranted to investigate the effects of these results on the general health of adults with DS and the impact of long-term exercise programs on these parameters.