Document Detail


Effect of beta-blockade on the premature ventricular beats/heart rate relation and heart rate variability in patients with coronary heart disease and severe ventricular arrhythmias.
MedLine Citation:
PMID:  11486156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We examined the effects of beta-blockers on the associations between heart rate and number of premature ventricular beats (PVBs) and on heart rate variability and myocardial ischemia in patients with coronary heart disease. After 2 weeks of run-in placebo treatment, 18 patients with coronary artery disease were randomized to a 7-day treatment with either propranolol (40 mg) three times a day or placebo. During run-in and after 7 days of treatment, patients underwent 24-hour Holter monitoring and exercise tests. We analyzed the 24-hour Holter recordings with customized software that computes the correlation between heart rate and occurrence of PVBs. We also computed spectral measures of heart rate variability on the same recordings. Propranolol caused a significant decrease in the log-transformed total number of PVBs recorded over 24 hours and during the day. The number of PVBs was much lower during the night than during the day both after placebo and after propranolol. There were no differences between the two treatments. During the day, there was a positive correlation between heart rate and the number of PVBs in all 18 patients. The mean correlation coefficients between heart rate and number of PVBs increased significantly after propranolol treatment both during the 24-hour monitoring (p < 0.05) and during the day (p < 0.05). The night-recorded correlation coefficients between heart rate and number of PVBs were not significantly different in the placebo versus propranolol group. Propranolol significantly increased the total power during the day. Placebo caused a significant decrease in the low-frequency band (LF) and a significant increase in the high-frequency band (HF) during the night compared with the day. During the day, propranolol significantly reduced LF power and increased HF power, with respect to placebo. After propranolol treatment, the values of LF and HF power during the day were comparable to those recorded at night. The LF/HF ratio decreased significantly after propranolol treatment with respect to placebo in the day and became similar to that recorded during sleep. Propranolol significantly reduced heart rate and systolic blood pressure at rest and at peak exercise and reduced signs of myocardial ischemia. Propranolol administration reduces PVBs in patients with coronary artery disease and severe ventricular arrhythmias possibly through an improvement of cardiac autonomic regulation and through anti-ischemic effects, antiarrhythmic effects, or both.
Authors:
D Acanfora; G D Pinna; M Gheorghiade; L Trojano; G Furgi; R Maestri; C Picone; G L Iannuzzi; F Marciano; F Rengo
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of therapeutics     Volume:  7     ISSN:  1075-2765     ISO Abbreviation:  Am J Ther     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2001-08-03     Completed Date:  2001-08-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9441347     Medline TA:  Am J Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  229-36     Citation Subset:  IM    
Affiliation:
Salvatore Maugeri Foundation, Institute of Care and Scientific Research, Rehabilitation Institute of Telese Terme, Benevento, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Aged
Anti-Arrhythmia Agents / therapeutic use*
Arrhythmias, Cardiac / drug therapy*,  physiopathology
Coronary Disease / drug therapy*,  physiopathology
Electrocardiography
Exercise Test
Female
Heart Rate / drug effects*
Heart Ventricles / physiopathology
Humans
Male
Middle Aged
Myocardial Ischemia / drug therapy,  physiopathology
Propranolol / therapeutic use*
Sympathetic Nervous System / drug effects
Vagus Nerve / physiopathology
Ventricular Premature Complexes / drug therapy*,  physiopathology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents; 525-66-6/Propranolol

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


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