Carvedilol reduces the inappropriate increase of ventilation during exercise in heart failure patients

Research output: Contribution to journalArticle

Abstract

Study objective: To evaluate the effects of β-blockers on ventilation in heart failure patients. Indeed, β-blockers ameliorate the clinical condition and cardiac function of heart failure patients, but not exercise capacity. Because ventilation is inappropriately elevated in heart failure patients due to overactive reflexes from ergoreceptors and chemoreceptors, we hypothesized that β-blockers can elicit their positive clinical effects through a reduction of ventilation. Design: This was a double-blind, randomized, placebo-controlled study. Setting: University hospital heart failure unit. Patients and interventions: While receiving placebo (2 months) and a full dosage of carvedilol (4 months), 15 chronic heart failure patients were evaluated by quality-of-life questionnaire, pulmonary function tests, cardiopulmonary exercise tests with constant workload, and a ramp protocol. Results: Therapy with carvedilol did not affect resting pulmonary function and exercise capacity. However, carvedilol improved the results of the quality-of-life questionnaire, reduced the mean (± SD) slope of the minute ventilation (VE)/carbon dioxide output (VCO2) ratio (from 36.4 ± 8.9 to 31.7 ± 3.8; p <0.01) and reduced ventilation at the following times: at peak exercise (from 60 ± 14 to 48 ± 15 L/min; p <0.05); during the intermediate phases of a ramp-protocol exercise; and during the steady-state phase of a constant-workload exercise (from 42 ± 14 to 34 ± 13 L/min; p <0.05, at third min). The end-expiratory pressure for carbon dioxide increased as ventilation decreased. The reduction in the VE/VCO2 ratio was correlated with improvement in quality of life (r = 0.603; p <0.02). Conclusions: Improvement in the clinical conditions of heart failure patients treated with carvedilol is associated with reductions in the inappropriately elevated ventilation levels observed during exercise.

Original languageEnglish
Pages (from-to)2062-2067
Number of pages6
JournalChest
Volume122
Issue number6
DOIs
Publication statusPublished - 2002

Fingerprint

Ventilation
Heart Failure
Exercise
Architectural Accessibility
Quality of Life
Workload
Carbon Dioxide
Placebos
carvedilol
Respiratory Function Tests
Exercise Test
Reflex
Pressure
Lung

Keywords

  • Carvedilol
  • Exercise
  • Heart failure
  • Oxygen uptake
  • Ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

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title = "Carvedilol reduces the inappropriate increase of ventilation during exercise in heart failure patients",
abstract = "Study objective: To evaluate the effects of β-blockers on ventilation in heart failure patients. Indeed, β-blockers ameliorate the clinical condition and cardiac function of heart failure patients, but not exercise capacity. Because ventilation is inappropriately elevated in heart failure patients due to overactive reflexes from ergoreceptors and chemoreceptors, we hypothesized that β-blockers can elicit their positive clinical effects through a reduction of ventilation. Design: This was a double-blind, randomized, placebo-controlled study. Setting: University hospital heart failure unit. Patients and interventions: While receiving placebo (2 months) and a full dosage of carvedilol (4 months), 15 chronic heart failure patients were evaluated by quality-of-life questionnaire, pulmonary function tests, cardiopulmonary exercise tests with constant workload, and a ramp protocol. Results: Therapy with carvedilol did not affect resting pulmonary function and exercise capacity. However, carvedilol improved the results of the quality-of-life questionnaire, reduced the mean (± SD) slope of the minute ventilation (VE)/carbon dioxide output (VCO2) ratio (from 36.4 ± 8.9 to 31.7 ± 3.8; p <0.01) and reduced ventilation at the following times: at peak exercise (from 60 ± 14 to 48 ± 15 L/min; p <0.05); during the intermediate phases of a ramp-protocol exercise; and during the steady-state phase of a constant-workload exercise (from 42 ± 14 to 34 ± 13 L/min; p <0.05, at third min). The end-expiratory pressure for carbon dioxide increased as ventilation decreased. The reduction in the VE/VCO2 ratio was correlated with improvement in quality of life (r = 0.603; p <0.02). Conclusions: Improvement in the clinical conditions of heart failure patients treated with carvedilol is associated with reductions in the inappropriately elevated ventilation levels observed during exercise.",
keywords = "Carvedilol, Exercise, Heart failure, Oxygen uptake, Ventilation",
author = "Piergiuseppe Agostoni and Marco Guazzi and Maurizio Bussotti and {De Vita}, Stefano and Pietro Palermo",
year = "2002",
doi = "10.1378/chest.122.6.2062",
language = "English",
volume = "122",
pages = "2062--2067",
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number = "6",

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TY - JOUR

T1 - Carvedilol reduces the inappropriate increase of ventilation during exercise in heart failure patients

AU - Agostoni, Piergiuseppe

AU - Guazzi, Marco

AU - Bussotti, Maurizio

AU - De Vita, Stefano

AU - Palermo, Pietro

PY - 2002

Y1 - 2002

N2 - Study objective: To evaluate the effects of β-blockers on ventilation in heart failure patients. Indeed, β-blockers ameliorate the clinical condition and cardiac function of heart failure patients, but not exercise capacity. Because ventilation is inappropriately elevated in heart failure patients due to overactive reflexes from ergoreceptors and chemoreceptors, we hypothesized that β-blockers can elicit their positive clinical effects through a reduction of ventilation. Design: This was a double-blind, randomized, placebo-controlled study. Setting: University hospital heart failure unit. Patients and interventions: While receiving placebo (2 months) and a full dosage of carvedilol (4 months), 15 chronic heart failure patients were evaluated by quality-of-life questionnaire, pulmonary function tests, cardiopulmonary exercise tests with constant workload, and a ramp protocol. Results: Therapy with carvedilol did not affect resting pulmonary function and exercise capacity. However, carvedilol improved the results of the quality-of-life questionnaire, reduced the mean (± SD) slope of the minute ventilation (VE)/carbon dioxide output (VCO2) ratio (from 36.4 ± 8.9 to 31.7 ± 3.8; p <0.01) and reduced ventilation at the following times: at peak exercise (from 60 ± 14 to 48 ± 15 L/min; p <0.05); during the intermediate phases of a ramp-protocol exercise; and during the steady-state phase of a constant-workload exercise (from 42 ± 14 to 34 ± 13 L/min; p <0.05, at third min). The end-expiratory pressure for carbon dioxide increased as ventilation decreased. The reduction in the VE/VCO2 ratio was correlated with improvement in quality of life (r = 0.603; p <0.02). Conclusions: Improvement in the clinical conditions of heart failure patients treated with carvedilol is associated with reductions in the inappropriately elevated ventilation levels observed during exercise.

AB - Study objective: To evaluate the effects of β-blockers on ventilation in heart failure patients. Indeed, β-blockers ameliorate the clinical condition and cardiac function of heart failure patients, but not exercise capacity. Because ventilation is inappropriately elevated in heart failure patients due to overactive reflexes from ergoreceptors and chemoreceptors, we hypothesized that β-blockers can elicit their positive clinical effects through a reduction of ventilation. Design: This was a double-blind, randomized, placebo-controlled study. Setting: University hospital heart failure unit. Patients and interventions: While receiving placebo (2 months) and a full dosage of carvedilol (4 months), 15 chronic heart failure patients were evaluated by quality-of-life questionnaire, pulmonary function tests, cardiopulmonary exercise tests with constant workload, and a ramp protocol. Results: Therapy with carvedilol did not affect resting pulmonary function and exercise capacity. However, carvedilol improved the results of the quality-of-life questionnaire, reduced the mean (± SD) slope of the minute ventilation (VE)/carbon dioxide output (VCO2) ratio (from 36.4 ± 8.9 to 31.7 ± 3.8; p <0.01) and reduced ventilation at the following times: at peak exercise (from 60 ± 14 to 48 ± 15 L/min; p <0.05); during the intermediate phases of a ramp-protocol exercise; and during the steady-state phase of a constant-workload exercise (from 42 ± 14 to 34 ± 13 L/min; p <0.05, at third min). The end-expiratory pressure for carbon dioxide increased as ventilation decreased. The reduction in the VE/VCO2 ratio was correlated with improvement in quality of life (r = 0.603; p <0.02). Conclusions: Improvement in the clinical conditions of heart failure patients treated with carvedilol is associated with reductions in the inappropriately elevated ventilation levels observed during exercise.

KW - Carvedilol

KW - Exercise

KW - Heart failure

KW - Oxygen uptake

KW - Ventilation

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