uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Exercise hemodynamics and myocardial metabolism during long-term beta-adrenergic blockade in severe heart failure
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Cardiology-arrhythmia)
1991 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 18, no 4, 1059-1066 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
1991. Vol. 18, no 4, 1059-1066 p.
Keyword [en]
Adrenergic beta-Antagonists/*therapeutic use, Cardiomyopathy; Dilated/*drug therapy, Energy Metabolism/drug effects, Epinephrine/blood, Exercise/*physiology, Female, Heart Failure; Congestive/*drug therapy, Hemodynamic Processes/drug effects/*physiology, Humans, Male, Metoprolol/*therapeutic use, Middle Aged, Myocardium/*metabolism, Norepinephrine/blood, Research Support; Non-U.S. Gov't, Time Factors
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-69346PubMedID: 1680132OAI: oai:DiVA.org:uu-69346DiVA: diva2:97257
Available from: 2005-03-31 Created: 2005-03-31 Last updated: 2010-05-28Bibliographically approved

Open Access in DiVA

No full text

Other links


Search in DiVA

By author/editor
Blomström-Lundqvist, C
By organisation
Department of Medical Sciences
In the same journal
Journal of the American College of Cardiology
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 136 hits
ReferencesLink to record
Permanent link

Direct link