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Selection of optimal dose of beta-blocker treatment in myocardial infarction patients based on changes in synchronization between 0.1 Hz oscillations in heart rate and peripheral microcirculation.
MedLine Citation:
PMID:  22343262     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Selection of the optimal dose of beta-blocker treatment in myocardial infarction (MI) patients is problematic because of a lack of well-established guidelines. METHODS: We evaluated changes in synchronization between 0.1 Hz oscillations in heart rate (HR) and plethysmographic peripheral microcirculation in response to a tilt-table test and to 3-month treatment with the highest tolerated beta-blocker (metoprolol) dose in 43 patients aged between 41 and 77 years with acute MI 6 months prior to the start of the study. Before the study the patients were treated with small doses of beta-blocker. Phase differences between HR and peripheral microcirculation oscillations were used to measure the degree of synchronization (S), and relative change in S from horizontal position was used to characterize the response to vertical tilt. RESULTS: Two groups of MI patients matched for clinical characteristics were identified on the basis of the results. The first group was composed of patients with decreased S as a response to vertical tilt at the beginning of the study. The patients with increased S during vertical tilt before treatment with the highest tolerated beta-blocker dose were attributed to the second group. The response to vertical tilt in the first group of patients was postulated to indicate the need to increase beta-blocker dose, and in turn, the response in the second group to indicate an already adequate beta-blocker dose. CONCLUSION: Assessment of synchronization of 0.1 Hz HR and peripheral microcirculation oscillations as a response to a tilt test can possibly be used as a guideline for selecting beta-blocker dose in post-MI patients.
Authors:
Anton R Kiselev; Vladimir I Gridnev; Mikhail D Prokhorov; Anatoly S Karavaev; Olga M Posnenkova; Vladimir I Ponomarenko; Boris P Bezruchko
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-15
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  -     ISSN:  1558-2035     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aSaratov Research Institute of Cardiology bSaratov State University, Saratov, Russia.
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