Document Detail


Acetylcholinesterase inhibition with pyridostigmine improves heart rate recovery after maximal exercise in patients with chronic heart failure.
MedLine Citation:
PMID:  12860856     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To characterise the effects of acetylcholinesterase inhibition with pyridostigmine on parasympathetic tone in patients with chronic heart failure (CHF). DESIGN: Prospective randomised, double blind crossover trial. SETTING: University hospital outpatient heart failure clinic. PATIENTS: 20 ambulatory subjects with stable CHF (mean age 55 years, mean ejection fraction 24%). INTERVENTIONS: Oral administration of a single dose of pyridostigmine 30 mg and matching placebo on separate days. MAIN OUTCOME MEASURES: Heart rate recovery at one minute and three minutes after completion of maximal exercise. RESULTS: Heart rate recovery at one minute after exercise was significantly greater after administration of pyridostigmine than after administration of placebo (mean (SEM) 27.4 (3.2) beats/min v 22.4 (2.4) beats/min, p < 0.01). Heart rate recovery at three minutes after exercise did not differ after administration of pyridostigmine and placebo (mean (SEM) 44.4 (3.9) beats/min v 41.8 (3.6) beats/min, NS). Peak heart rate, peak oxygen uptake, peak respiratory exchange ratio, plasma noradrenaline (norepinephrine) concentrations, and plasma brain natriuretic peptide concentrations did not differ after administration of pyridostigmine and placebo. CONCLUSIONS: Acetylcholinesterase inhibition with pyridostigmine increased heart rate recovery at one minute but not at three minutes after exercise. A specific effect of pyridostigmine on heart rate one minute after exercise suggests that pyridostigmine augments parasympathetic tone in patients with CHF.
Authors:
A S Androne; K Hryniewicz; R Goldsmith; A Arwady; S D Katz
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  89     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-15     Completed Date:  2003-09-02     Revised Date:  2010-04-29    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  854-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiac Output, Low / drug therapy*,  physiopathology
Cholinesterase Inhibitors / therapeutic use*
Cross-Over Studies
Double-Blind Method
Exercise / physiology*
Female
Heart Rate / drug effects
Humans
Male
Middle Aged
Prospective Studies
Pyridostigmine Bromide / therapeutic use*
Grant Support
ID/Acronym/Agency:
5 MO1 RR00125/RR/NCRR NIH HHS; HL K24-04024/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cholinesterase Inhibitors; 101-26-8/Pyridostigmine Bromide
Comments/Corrections

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