Karnik Rahool S, Lewis William, Miles Peter, Baker Larry
Division of Cardiovascular Medicine, Rhode Island Hospital, Providence, RI, USA.
Prev Cardiol. 2008 Winter;11(1):26-8. doi: 10.1111/j.1520-037x.2007.07310.x.
The purpose of this study was to determine the effects of beta-blockers (BBs) on heart rate recovery (HRR) following exercise stress testing. HRR is a predictor of mortality following exercise stress testing and is thought to be due to reinstitution of vagal tone. Exercise testing in the presence of BBs should have no effect on reinstitution of vagal tone and therefore no effect on HRR. One published study contradicts this understanding. The authors performed a retrospective analysis of the University of California, Davis, treadmill database and found 334 patients who underwent exercise stress echocardiography (ESE) with complete data. Patients undergoing ESE without a BB were compared with patients who were receiving a BB. HRR was not affected by BB use in patients without stress-induced echocardiographic abnormalities (negative ESE result). In patients with stress-induced echocardiographic abnormalities (positive ESE result), HRR was delayed compared with patients with negative ESE. BB use improved HRR in patients with positive ESE. BBs do not affect HRR in patients with a negative ESE result, and HRR can be used for mortality prediction. In patients with a positive ESE result, HRR is improved in the presence of a BB.
本研究的目的是确定β受体阻滞剂（BBs）对运动应激试验后心率恢复（HRR）的影响。HRR是运动应激试验后死亡率的一个预测指标，被认为是由于迷走神经张力的恢复所致。在使用BBs的情况下进行运动试验应对迷走神经张力的恢复没有影响，因此对HRR也没有影响。一项已发表的研究与这种认识相矛盾。作者对加利福尼亚大学戴维斯分校的跑步机数据库进行了回顾性分析，发现334例接受运动应激超声心动图（ESE）且数据完整的患者。将未使用BBs进行ESE的患者与正在接受BBs治疗的患者进行比较。在没有应激诱发超声心动图异常（ESE结果为阴性）的患者中，使用BBs对HRR没有影响。在有应激诱发超声心动图异常（ESE结果为阳性）的患者中，与ESE结果为阴性的患者相比，HRR延迟。在ESE结果为阳性的患者中，使用BBs可改善HRR。BBs对ESE结果为阴性的患者的HRR没有影响，并且HRR可用于死亡率预测。在ESE结果为阳性的患者中，使用BBs可改善HRR。
