| The impact of pharmacotherapy on the cardiopulmonary exercise test response in patients with heart failure: a mini review. | |
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MedLine Citation:
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PMID: 19485908 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiopulmonary exercise testing (CPX) is a well-recognized assessment technique in patients with HF. Ventilatory efficiency, aerobic capacity and heart rate recovery are several parameters obtained from CPX that accurately reflect physiologic function and provide robust prognostic information. Pharmacotherapy is a vital component to the management of patients with HF. Numerous pharmacologic interventions, such as ACE inhibition and beta-blockade have demonstrated significant physiologic and prognostic improvement in this population. Furthermore, a number of investigations demonstrating a positive change in the CPX response resulting from a pharmacologic intervention now exist. Because CPX variables reflect pathophysiologic processes differently, their response to a given pharmacologic is unique. For example, beta-blockade has been shown to significantly improve ventilatory efficiency, one of the most powerful prognostic markers obtained from CPX, while not altering aerobic capacity or heart rate recovery. Conversely, ACE and phosphodiesterase-5 inhibition appears to improve ventilatory efficiency and aerobic capacity. Given the prognostic value of CPX, gauging its improvement from pharmacotherapy may be advantageous in facilitating optimal titration of medications. A comprehensive review describing the physiologic and prognostic importance of CPX in the context of pharmacotherapy does not exist. This mini review will: 1. Identify key CPX variables obtained from CPX including aerobic capacity, ventilatory efficiency and heart rate recovery, 2. Describe the physiologic and prognostic significance of CPX in the heart failure population, and, 3. Summarize the present body of evidence addressing the change in CPX in response to different pharmacologic interventions including beta-blockade, renin-angiotensin-aldosterone axis inhibition and sildenafil. |
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Authors:
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Marco Guazzi; Ross Arena |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current vascular pharmacology Volume: 7 ISSN: 1875-6212 ISO Abbreviation: Curr Vasc Pharmacol Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-28 Completed Date: 2010-01-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101157208 Medline TA: Curr Vasc Pharmacol Country: United Arab Emirates |
Other Details:
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Languages: eng Pagination: 557-69 Citation Subset: IM |
Affiliation:
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Cardiopulmonary Laboratory, Cardiology Division, University of Milano, San Paolo Hospital, Milano, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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pharmacology*,
therapeutic use Angiotensin-Converting Enzyme Inhibitors / pharmacology*, therapeutic use Electrocardiography Exercise Test* Heart Failure / drug therapy, physiopathology* Hemodynamics / physiology Humans Oxygen Consumption / physiology Phosphodiesterase Inhibitors / pharmacology*, therapeutic use Pulmonary Ventilation / physiology |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Phosphodiesterase Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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