Effects of cold exposure on submaximal exercise performance and adrenergic activation in patients with congestive heart failure and the effects of beta-adrenergic blockade (carvedilol or metoprolol)
Blanchet M, Ducharme A, Racine N, Rouleau JL, Tardif JC, Juneau M, Marquis J, Larivée L, Nigam A, Fortier A, White M
The American journal of cardiology · 16 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Organización sin fines de lucro
- Heart and Stroke Foundation of Canada
Según 1 financiador declarado.
Publicación
- Publicado
- 2003-09-01 · Am J Cardiol · vol. 92 · número 5 · págs. 548–553
- Editorial
- Elsevier BV
- Citado
- 21 citas · más que el 90% de estudios similares · 3.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 23 trabajos
- Acceso
- De pago
- Áreas de investigación
- Cardiovascular and exercise physiology · Thermoregulation and physiological responses · Heart rate and cardiovascular health
- Palabras clave
- congestive heart failure, cold exposure, submaximal exercise capacity, beta-adrenergic blockade, carvedilol, metoprolol, norepinephrine, adrenergic stimulation, exercise endurance, cold sensitivity
- MeSH
- humans, dyspnea, norepinephrine, propanolamines, metoprolol, carbazoles, receptors, adrenergic, adrenergic beta-antagonists, stroke volume, exercise test, blood gas analysis, case-control studies, prospective studies, single-blind method, physical endurance, exercise tolerance, aged, middle aged, female, male, heart failure, cold temperature, carvedilol
11 autores
- Martine Blanchet🇨🇦Montreal Heart Institute
- Anique Ducharme
- Normand Racine
- Jean Lucien Rouleau
- Jean‐Claude Tardif
- Martin Juneau🇨🇦Montreal Heart Institute
- Johanne Marquis
- Lucie Larivée🇨🇦Montreal Heart Institute
- Anil Nigam
- Anick Fortier
- Michel White · autor de correspondencia
Resumen
El texto original del estudio, en el idioma en que se publicó.
Patients with congestive heart failure (CHF) exhibit a decrease in maximal exercise capacity in response to a cold environment. The aim of this study was to further investigate the impact of cold exposure on submaximal exercise capacity, systemic adrenergic drive, and the effects of long-term beta-adrenergic blockade on these parameters. Thirty-three patients with CHF, with exercise limited by dyspnea and left ventricular ejection fraction of 26 +/- 4%, were randomized to receive metoprolol or carvedilol for 6 months. The observations were compared with 12 age-matched healthy volunteers. Maximal exercise performance with gas exchange analyses were assessed using a ramp protocol, and endurance capacity was measured using 2 constant-load exercise tests performed randomly at 20 degrees C and -8 degrees C. Healthy volunteers increased their submaximal exercise time by 20% (1,353 +/- 455 [20 degrees C] vs 1,635 +/- 475 seconds [-8 degrees C]; p <0.05), whereas patients with CHF exhibited a 21% decrease in exercise time (1,182 +/- 549 [20 degrees C] vs 931 +/- 524 seconds [-8 degrees C]; p <0.05) at -8 degrees C. Beta blockers increased submaximal exercise duration at 20 degrees C (+261 +/- 617 seconds; p <0.05) and -8 degrees C (+374 +/- 729 seconds; p <0.05). Norepinephrine increased to a greater extent at 4 minutes and at the time of exhaustion (at -8 degrees C) only in patients with CHF. Beta-adrenergic blockade caused no significant decrease in plasma norepinephrine levels. Patients with symptomatic CHF exhibited a significant decrease in submaximal exercise time in response to moderate cold exposure. Beta-blocker therapy with either metoprolol or carvedilol significantly increases submaximal exercise time and attenuates the impact of cold exposure on functional capacity.
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