| Negative chronotropic effect of beta-blockade therapy reduces myocardial oxygen expenditure for nonmechanical work. | |
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MedLine Citation:
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PMID: 8759074 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The negative chronotropic effect of beta-blocking agents is likely to provide hemodynamic and energetic advantages. However, the negative chronotropic effect on cardiac energetics observed on the initiation of beta-blockade therapy has not been fully elucidated. METHODS AND RESULTS: In 18 patients with heart failure, left ventricular pressure and volume, external work (EW), myocardial oxygen consumption per beat (total Vo2), mechanical efficiency (EW/total Vo2), and Vo2 for nonmechanical work (total Vo2-2.EW) were measured with the use of conductance catheter and Webster catheter at the following three states: under control conditions and after beta-blockade (0.15 +/- 0.07 mg/kg propranolol IV) with and without atrial pacing to keep the heart rate at control levels. Heart rate decreased after atrial pacing was stopped. EW decreased during beta-blockade with pacing and returned to the control level after pacing was stopped. Total Vo2 did not change during beta-blockade with or without pacing, whereas Vo2 for nonmechanical work increased with pacing and returned to the control level after pacing was stopped. As a result, mechanical efficiency decreased during beta-blockade with pacing and returned to the control level after pacing was stopped. CONCLUSIONS: The negative chronotropic effect of a beta-blocking agent may offset the mechanoenergetical deterioration resulting from its negative inotropic effect through a reduction in oxygen expenditure for nonmechanical work. These findings suggest that the negative chronotropic effect is an important aspect of beta-blockade therapy. |
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Authors:
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H Yamakawa; M Takeuchi; H Takaoka; K Hata; M Mori; M Yokoyama |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 94 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1996 Aug |
Date Detail:
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Created Date: 1996-12-11 Completed Date: 1996-12-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 340-5 Citation Subset: AIM; IM |
Affiliation:
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First Department of Internal Medicine, Kobe University School of Medicine, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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pharmacology* Adult Animals Blood Pressure / drug effects Blood Volume / drug effects Cardiac Output, Low / physiopathology Cardiac Pacing, Artificial Energy Metabolism / drug effects Female Heart Rate / drug effects* Hemodynamics / drug effects Humans Male Myocardium / metabolism* Oxygen Consumption / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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