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耐力训练的血压正常受试者以及接受β受体阻滞剂(普萘洛尔和吲哚洛尔)治疗的未经训练的高血压受试者在次最大运动期间的心输出量。

Stroke volume during submaximal exercise in endurance-trained normotensive subjects and in untrained hypertensive subjects with beta blockade (propranolol and pindolol).

作者信息

Scruggs K D, Martin N B, Broeder C E, Hofman Z, Thomas E L, Wambsgans K C, Wilmore J H

机构信息

Department of Kinesiology and Health Education, University of Texas, Austin 78712.

出版信息

Am J Cardiol. 1991 Feb 15;67(5):416-21. doi: 10.1016/0002-9149(91)90052-m.

Abstract

The effect of beta-adrenergic blockade on stroke volume (SV) at increasing submaximal exercise intensities was studied in 12 endurance-trained normotensive and 12 untrained hypertensive (diastolic blood pressure greater than 95 mm Hg) men, aged 18 to 34 years. Subjects were assigned to each of 3 treatments in a double-blind, randomized order: placebo, propranolol (80 mg twice daily) and pindolol (10 mg twice daily) for 10 days, with a period of 48 to 60 hours from the initial dose to the first treadmill test and a 4-day washout period between drugs. Cardiac output was measured using the carbon dioxide rebreathing method and SV was calculated from cardiac output and heart rate as follows: SV = cardiac output/heart rate. Cardiac outputs were estimated at rest and while walking on a treadmill at 25, 45, 60 and 75% of the subject's previously determined maximal oxygen uptake (VO2max). No significant differences were found in cardiac output between either of the drugs and placebo at rest, or at any of the 4 rates of work. Propranolol significantly increased SV above placebo values (p less than 0.05) for both trained and untrained groups at the intensities of 45, 60 and 75%. Significant differences in SV were found between pindolol and placebo only at the intensities of 60 and 75% in the trained group. Contrary to expectations, SV showed no indication of a plateau with propranolol in the trained subjects throughout the 4 different exercise intensities, whereas a plateau was established under placebo conditions by 45% of VO2max in both trained and untrained subjects. These results suggest that both trained and untrained hypertensive persons can exercise with beta-adrenergic blockade at submaximal levels without compromised cardiac function.

摘要

在12名经过耐力训练的血压正常男性和12名未经训练的高血压(舒张压大于95毫米汞柱)男性(年龄在18至34岁之间)中,研究了β-肾上腺素能阻滞剂在亚最大运动强度增加时对每搏输出量(SV)的影响。受试者以双盲、随机顺序接受3种治疗中的每一种:安慰剂、普萘洛尔(每日两次,每次80毫克)和吲哚洛尔(每日两次,每次10毫克),持续10天,从初始剂量到首次跑步机测试的时间为48至60小时,两种药物之间有4天的洗脱期。使用二氧化碳重呼吸法测量心输出量,并根据心输出量和心率计算SV,如下所示:SV = 心输出量/心率。在静息状态以及在跑步机上以受试者先前确定的最大摄氧量(VO2max)的25%、45%、60%和75%行走时估计心输出量。在静息状态或任何4种工作速率下,两种药物与安慰剂之间的心输出量均未发现显著差异。在45%、60%和75%的强度下,普萘洛尔使训练组和未训练组的SV均显著高于安慰剂值(p < 0.05)。仅在训练组中,吲哚洛尔与安慰剂之间的SV在60%和75%的强度下存在显著差异。与预期相反,在整个4种不同运动强度下,训练有素的受试者中,SV未显示出普萘洛尔作用下的平台期迹象,而在安慰剂条件下,训练有素和未训练的受试者在VO2max的45%时均建立了平台期。这些结果表明,训练有素和未训练的高血压患者在亚最大水平进行β-肾上腺素能阻滞剂治疗的运动时,心脏功能不会受到损害。

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