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Titolo:
Autonomic dysfunction in patients with mild heart failure and coronary artery disease and the effects of add-on beta-blockade
Autore:
Tjeerdsma, G; Szabo, BM; van Wijk, LM; Brouwer, J; Tio, RA; Crijns, HJGM; van Veldhuisen, DJ;
Indirizzi:
Refaja Hosp, Dept Cardiol, Stadskanaal, Netherlands Refaja Hosp Stadskanaal Netherlands t Cardiol, Stadskanaal, Netherlands Univ Groningen Hosp, Thoraxctr, Dept Cardiol, NL-9700 RB Groningen, Netherlands Univ Groningen Hosp Groningen Netherlands NL-9700 RB ningen, Netherlands
Titolo Testata:
EUROPEAN JOURNAL OF HEART FAILURE
fascicolo: 1, volume: 3, anno: 2001,
pagine: 33 - 39
SICI:
1388-9842(200101)3:1<33:ADIPWM>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR DYSFUNCTION; ACUTE MYOCARDIAL-INFARCTION; RATE-VARIABILITY; ACTIVATION; VARIABLES; TRIAL;
Keywords:
beta-adrenergic receptor blockers; autonomic failure; heart rate variability;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: van Veldhuisen, DJ Netherlands Heart Fdn, The Hague, Netherlands Netherlands Heart Fdn The Hague Netherlands herlands
Citazione:
G. Tjeerdsma et al., "Autonomic dysfunction in patients with mild heart failure and coronary artery disease and the effects of add-on beta-blockade", EUR J HE FA, 3(1), 2001, pp. 33-39

Abstract

Aim: Autonomic impairment is related to the incidence of sudden death in chronic heart failure (CHF). Our objective was to study autonomic profiles in patients with mild CHF due to coronary artery disease, and to investigatethe value of add-on P-blockade. Methods and results: Measures of autonomicfunction (plasma norepinephrine, heart rate [HR] variability, autonomic function testing), and exercise capacity, were compared between 24 patients with mild CHF, and 24 healthy controls. In this mechanistic study, we assessed the effect of 26 weeks metoprolol treatment in a double-blind, randomized, placebo-controlled design. All patients received metoprolol sustained release (200 mg; n = 12) or placebo (n = 12). Assessments were made at baseline and after 10 and 26 weeks' treatment. At baseline, norepinephrine levelswere elevated, while HR variability parameters were decreased in patients vs. controls (both P < 0.05). Autonomic function testing showed only small differences, although significant alterations were observed with deep breathing and head up tilting, (both P < 0.05). After 26 weeks', metoprolol did not affect exercise capacity or norepinephrine concentrations. In contrast,HR variability was markedly improved in metoprolol-treated patients vs. placebo-treated patients (P < 0.05). In particular, a shift toward normal in the sympathovagal balance was observed (P<0.05). Autonomic function testingshowed only small, and generally non-significant trends after metoprolol. Conclusions: Marked autonomic abnormalities are already present in mild CHF, which may be (partially) reversed by metoprolol. These observations support the reported reduction of sudden death by P-blockade in patients with CHF. (C) 2001 European Society of Cardiology. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:06:12