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比索洛尔对心力衰竭患者心功能及运动能力的影响。

Effects of bisoprolol on cardiac function and exercise in patients with heart failure.

作者信息

Issa Victor Sarli, Guimarães Guilherme Vieira, Rezende Marcos Valério Coimbra, Cruz Fátima das Dores, Ferreira Silvia Moreira Ayub, Bacal Fernando, Bocchi Edimar Alcides

机构信息

Instituto do Coração, FM, USP, São Paulo, SP, Brazil.

出版信息

Arq Bras Cardiol. 2007 Mar;88(3):340-5. doi: 10.1590/s0066-782x2007000300014.

Abstract

OBJECTIVE

To assess the effects of bisoprolol on exercise capacity and ventricular function in patients with heart failure.

METHODS

Clinical and hemodynamic variables, ventricular function and remodeling, and ergospirometry of patients with heart failure of different etiologies were evaluated before and after the administration of bisoprolol.

RESULTS

Twenty-two patients were analyzed; one patient did not tolerate medication and 14 patients reached the study goal. The group consisted of 9 men and 5 women, the mean age was 52 (36-64) years, and patients were followed during 551 days (238-1109). We observed an improvement in NYHA functional class, reduction in resting heart rate (78.8+/-8.7 vs 63+/-6.4 bpm, p <0.001), increase in left ventricular ejection fraction (31.3+/-8.5% vs 39+/-14.7%. p=0.043), and a tendency towards improved quality of life scores (31+/-20.6 vs 17.8+/-14.8. p=0.058). The maximum heart rate dropped during exercise (138.1+/-20.2 vs 116.7+/-27.1. p=0.01), as did peak oxygen consumption (20.9+/-6.8 vs 15.1+/-3.5. p<0.001); no change was observed on the EV/VCO2 slope. The effects were observed for all etiologies, including Chagas disease.

CONCLUSION

Bisoprolol was safe and well tolerated in patients with heart failure. Bisoprolol therapy improved the symptoms, hemodynamic variables, as well as the cardiac function for all etiologies; however, it did not result in improved exercise capacity.

摘要

目的

评估比索洛尔对心力衰竭患者运动能力和心室功能的影响。

方法

对不同病因的心力衰竭患者在服用比索洛尔前后进行临床和血流动力学变量、心室功能与重塑以及运动心肺功能测试评估。

结果

分析了22例患者;1例患者不耐受药物,14例患者达到研究目标。该组包括9名男性和5名女性,平均年龄为52(36 - 64)岁,患者随访了551天(238 - 1109天)。我们观察到纽约心脏协会(NYHA)功能分级改善,静息心率降低(78.8±8.7次/分钟对63±6.4次/分钟,p<0.001),左心室射血分数增加(31.3±8.5%对39±14.7%,p = 0.043),且生活质量评分有改善趋势(31±20.6对17.8±14.8,p = 0.058)。运动时最大心率下降(138.1±20.2对116.7±27.1,p = 0.01),峰值耗氧量也下降(20.9±6.8对15.1±3.5,p<0.001);呼气末二氧化碳分压与二氧化碳产生量比值(EV/VCO2)斜率未观察到变化。所有病因(包括恰加斯病)均观察到这些效果。

结论

比索洛尔在心力衰竭患者中安全且耐受性良好。比索洛尔治疗改善了所有病因患者的症状、血流动力学变量以及心脏功能;然而,它并未改善运动能力。

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