Document Detail


Nonselective beta-adrenergic blockade with carvedilol does not hinder the benefits of exercise training in patients with congestive heart failure.
MedLine Citation:
PMID:  9107160     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Long-term beta-adrenergic blockade does not appear to be associated with drug-induced training in patients with congestive heart failure (CHF); whether exercise training can increase peak aerobic capacity in patients with CHF who are treated with beta-adrenergic blockers is currently unknown. METHODS AND RESULTS: We studied 23 patients with CHF who were treated with carvedilol or propranolol in addition to ACE inhibitors, furosemide, and digoxin. Of the patients treated with carvedilol, 8 underwent exercise training and 8 remained sedentary. All 7 patients treated with propranolol underwent exercise training. Peak oxygen consumption (mL.kg-1.min-1) was serially measured in trained and sedentary patients. Peak reactive hyperemia (mL.min-1.100 mL-1) was determined in the calf and forearm immediately before and after 12 weeks of training. The peak oxygen consumption of trained patients treated with either carvedilol or propranolol increased from 12.9 +/- 1.4 to 16.0 +/- 1.6 (P < .001) and 12.4 +/- 1.0 to 15.7 +/- 0.9 (P < .001) mL.kg-1.min-1, respectively, whereas it did not change in the sedentary patients. Peak reactive hyperemia increased significantly in the calves but not the forearms of trained patients. CONCLUSIONS: Long-term, nonselective beta-adrenergic blockade with carvedilol or propranolol does not prevent patients with CHF from deriving systemic and regional benefits from physical training.
Authors:
L Demopoulos; M Yeh; M Gentilucci; M Testa; R Bijou; S D Katz; D Mancini; M Jones; T H LeJemtel
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  95     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-05-13     Completed Date:  1997-05-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1764-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological / drug effects*
Adrenergic beta-Antagonists / administration & dosage,  adverse effects*,  pharmacology,  therapeutic use
Aerobiosis
Aged
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  therapeutic use
Carbazoles / administration & dosage,  adverse effects*,  pharmacology,  therapeutic use
Cardiotonic Agents / administration & dosage,  therapeutic use
Digoxin / administration & dosage,  therapeutic use
Diuretics / administration & dosage,  therapeutic use
Drug Therapy, Combination
Exercise Therapy*
Female
Forearm / blood supply
Furosemide / administration & dosage,  therapeutic use
Heart / drug effects*,  physiopathology
Heart Failure / drug therapy*,  rehabilitation
Humans
Hyperemia / etiology
Leg / blood supply
Male
Middle Aged
Oxygen Consumption / drug effects*
Propanolamines / administration & dosage,  adverse effects*,  pharmacology,  therapeutic use
Propranolol / administration & dosage,  pharmacology,  therapeutic use
Receptors, Adrenergic, beta / physiology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Carbazoles; 0/Cardiotonic Agents; 0/Diuretics; 0/Propanolamines; 0/Receptors, Adrenergic, beta; 20830-75-5/Digoxin; 525-66-6/Propranolol; 54-31-9/Furosemide; 72956-09-3/carvedilol

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


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