摘要
晕厥是严重心力衰竭患者预后不良的征象。扩张型心肌病（DC）患者出现晕厥的原因尚未完全阐明，即使标准化评估后仍不明确。本研究的目的为观察神经介导机制在DC患者晕厥发作的病理生理学中的作用。26例左室射血分数≤40％的DC患者（21例男性，5例女性，平均年龄59±2岁，极差38～79岁）人选本研究。13例发生不明原因晕厥或前晕厥的患者及13例无不明原因晕厥的患者进行氯米帕明激发直立倾斜试验。两组患者在年龄、性别和左室射血分数方面相匹配，所采用药物治疗也没有显著差别。倾斜试验过程中进行心率变异性分析和前臂血流体积描记，同时采集血样测定儿茶酚胺浓度。
Syncope in patients With advanced heart failure is a sign of poor prognosis. The cause of syncope in patients with dilated eardiomyopathy（DC） is not fully recognized and may remain elusive even after standardized evaluation. The purpose of the present study was to examine the implication of neurally mediated mechanisms in the pathophysiology of syncopal episodes in patients with DC. Twenty-six patients（21 men, 5 ：women; mean age 59 ＋2 years, range .38 to 79,） with DC and left ventrieular ejection fractions ≤ 40% were included in the study Thirteen patients with unexplained syncope or presyncope and a control group of 13 patients without unexplained syncope underwent head-up tilt tests with clomipramine challenge.
