Document Detail


Deleterious effects of beta-blockers on exercise capacity and hemodynamics in patients with portopulmonary hypertension.
MedLine Citation:
PMID:  16401475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: It has been suggested that beta-blockers might be harmful in pulmonary arterial hypertension. However, no study has evaluated the effect of beta-blockers in these patients. The aim of this study was to investigate the effect of beta-blockers on exercise capacity and pulmonary hemodynamics in patients with portopulmonary hypertension receiving beta-blockers for the prophylaxis of variceal bleeding. METHODS: Ten consecutive patients with moderate to severe portopulmonary hypertension (mean pulmonary artery pressure of 52 [10] mm Hg) underwent a 6-minute walk test and a right heart catheterization at baseline and 2 (1) months after beta-blocker withdrawal. RESULTS: Following beta-blocker withdrawal, 9 of 10 patients increased their 6-minute walked distance with a mean increase in the whole group of 79 (78) meters (P = .01). Cardiac output increased by 28% (P < .01) with no change in mean pulmonary artery pressure, resulting in a 19% decrease in pulmonary vascular resistance (P < .01). Increases in cardiac output were related to a 25% increase in heart rate (P < .01), whereas stroke volume was unchanged (P = .65). The improvements in exercise tolerance were associated with increases in chronotropic response (maximal heart rate minus resting heart rate) from 18 (9) to 34 (12) beats/min (P < .01) during the 6-minute walk test. CONCLUSIONS: In patients with moderate to severe portopulmonary hypertension, beta-blockers are associated with significant worsening in exercise capacity and pulmonary hemodynamics. These deleterious effects support the contraindication of beta-blockers in patients with portopulmonary hypertension.
Authors:
Steeve Provencher; Philippe Herve; Xavier Jais; Didier Lebrec; Marc Humbert; Gerald Simonneau; Olivier Sitbon
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gastroenterology     Volume:  130     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-10     Completed Date:  2006-02-07     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  120-6     Citation Subset:  AIM; IM    
Affiliation:
Centre des Maladies Vasculaires Pulmonaires (UPRES EA 2705), Service de Pneumologie, Hôpital Antoine Béclère, Clamart, France. steeveprovencher@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / adverse effects*,  therapeutic use
Adult
Aged
Cardiac Output / drug effects
Drug-Induced Liver Injury
Exercise / physiology*
Female
Heart Rate / drug effects
Humans
Hypertension, Portal / drug therapy*
Hypertension, Pulmonary / drug therapy*
Male
Middle Aged
Physical Fitness
Walking / physiology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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