| The effects of long-term beta-blockade on the ventilatory responses to exercise in chronic heart failure. | |
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MedLine Citation:
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PMID: 15921802 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Chronic heart failure (CHF) patients complain of breathlessness and fatigue. Beta-blockers improve symptoms, echocardiograpahic variables and prognosis in CHF, but their effect on exercise capacity remains unclear. The aim of this study was to describe the effects of long-term beta-blocker therapy on metabolic gas exchange variables and ventilation during exercise in CHF patients. METHODS: 42 patients with symptomatic heart failure due to left ventricular systolic dysfunction (ejection fraction 33.2 (8.2)) on loop diuretics and angiotensin-converting enzyme inhibitors or angiotensin II antagonists, underwent exercise testing with metabolic gas exchange. They were then initiated onto and uptitrated to the maximum tolerated dose of beta-blockers. After 1 year of follow-up, patients were invited back for repeat testing. RESULTS: 35 patients attended for repeat exercise testing. Four patients had died, and three had not tolerated beta-blockade. After 1 year, exercise time was increased (487 (221) vs. 500 (217), p<0.05), and peak oxygen consumption and V(E)/V(CO(2)) slope were unchanged (20.9 (5.0) vs. 20.0 (5.4), p=0.15 and 36.7 (8.3) vs. 37.3 (7.8), p=0.70). Peak ventilation, (61.5 (12.9) vs. 57.1 (13.4), p<0.05), peak carbon dioxide production (1629 (404) vs. 1496 (375), p<0.02) and hence respiratory exchange ratio (1.02 (0.08) vs. 0.98 (0.06) p<0.02) and p<0.05) were reduced. Submaximal oxygen consumption and carbon dioxide production were lower at matched workloads. The slope relating symptoms to ventilation (Borg/V(E) slope) was less steep following beta-blockade (0.18 (0.09) vs. 0.15 (0.06), p<0.05). CONCLUSION: Long term beta-blocker therapy increases exercise time but not peak oxygen consumption, and reduces peak carbon dioxide production. CHF patients are less symptomatic for a given ventilation during exercise following beta-blocker treatment. |
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Authors:
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Klaus K A Witte; Simon Thackray; Nikolay P Nikitin; John G F Cleland; Andrew L Clark |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of heart failure Volume: 7 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2005 Jun |
Date Detail:
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Created Date: 2005-05-30 Completed Date: 2005-09-27 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 612-7 Citation Subset: IM |
Affiliation:
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Academic Cardiology, Castle Hill Hospital, Castle Road, Cottingham Hull HU16 5JQ, UK. klauswitte@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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pharmacology* Aged Bisoprolol / pharmacology* Carbazoles / pharmacology* Exercise Test Heart Failure / physiopathology*, ultrasonography Hemodynamics / drug effects Humans Middle Aged Oxygen Consumption / drug effects Propanolamines / pharmacology* Respiration / drug effects* Ventricular Function, Left / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Propanolamines; 66722-44-9/Bisoprolol; 72956-09-3/carvedilol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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