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Exercise hemodynami...
Exercise hemodynamics and myocardial metabolism during long-term beta-adrenergic blockade in severe heart failure.
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- Andersson, Bert, 1952 (författare)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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- Blomström-Lundqvist, C (författare)
- Uppsala universitet,Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute,Institutionen för medicinska vetenskaper,Cardiology-arrhythmia
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Hedner, T (författare)
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- Waagstein, Finn, 1938 (författare)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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(creator_code:org_t)
- 1991
- 1991
- Engelska.
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Ingår i: Journal of the American College of Cardiology. - 0735-1097 .- 1558-3597. ; 18:4, s. 1059-66
- Relaterad länk:
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http://www.ncbi.nlm....
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https://gup.ub.gu.se...
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Abstract
Ämnesord
Stäng
- Hemodynamics and myocardial metabolism at rest and during exercise were investigated in 21 patients with heart failure. The patients were evaluated before and after long-term treatment (14 +/- 7 months) with the beta-adrenergic blocking agent metoprolol. Clinical improvement with increased functional capacity occurred during treatment. Maximal work load increased by 25% (104 to 130 W; p less than 0.001). Hemodynamic data showed an increased cardiac index (3.8 to 4.6 liters/min per m2; p less than 0.02) during exercise. Pulmonary capillary wedge pressure decreased at rest (20 to 13 mm Hg; p less than 0.01) and during exercise (32 to 28 mm Hg; p = NS). Stroke volume index (30 to 39 g.m/m2; p less than 0.006) and stroke work index (28 to 46 g.m/m2; p less than 0.006) increased during exercise and long-term metoprolol treatment. The arterial norepinephrine concentration decreased at rest (3.72 to 2.19 nmol/liter; p less than 0.02) but not during exercise (13.2 to 11.1 nmol/liter; p = NS). The arterial-coronary sinus norepinephrine difference suggested a decrease in myocardial spillover during metoprolol treatment (-0.28 to -0.13 nmol/liter; p = NS at rest and -1.13 to -0.27 nmol/liter; p less than 0.05 during exercise). Coronary sinus blood flow was unchanged during treatment. Four patients produced myocardial lactate before the study, but none produced lactate after beta-blockade (p less than 0.05). There was no obvious improvement in a subgroup of patients with ischemic cardiomyopathy. In summary, there were signs of increased myocardial work load without higher metabolic costs after treatment with metoprolol.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Adrenergic beta-Antagonists
- therapeutic use
- Cardiomyopathy
- Dilated
- drug therapy
- Energy Metabolism
- drug effects
- Epinephrine
- blood
- Exercise
- physiology
- Female
- Heart Failure
- drug therapy
- Hemodynamics
- drug effects
- physiology
- Humans
- Male
- Metoprolol
- therapeutic use
- Middle Aged
- Myocardium
- metabolism
- Norepinephrine
- blood
- Time Factors
- Adrenergic beta-Antagonists/*therapeutic use
- MEDICINE
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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