Tesch P A
Sports Med. 1985 Nov-Dec;2(6):389-412. doi: 10.2165/00007256-198502060-00002.
beta-Adrenoceptor blockers (beta-blockers) are common first-choice drugs in the treatment of various cardiovascular disorders. Physical exercise performed during single-dose administration of beta-blockers, however, is associated with an increased rate of perceived exertion; an effect which appears to be partly reduced with long term treatment. Although clinical doses of beta-blockade may reduce heart rate by 30 to 35%, during maximal exercise cardiac output is not equally reduced. Accordingly, most studies have demonstrated increased stroke volume after beta-blockade. This reduction in heart rate is typically accompanied by a decreased VO2max (5 to 15%) in both patients and healthy, trained subjects. This smaller reduction in VO2max, as compared with the decrease in cardiac output, is the result of a partly compensating increased arteriovenous O2 difference. Work capacity as reflected by the ability to perform intense short term or more prolonged steady-state exercise is also impaired following beta-blockade. beta-Adrenoceptors can be subdivided into types beta 1- and beta 2. Blockers which are specific for either beta 1-receptors (beta 1-selective blockers) or both beta 1- and beta 2 receptors (non-selective blockers) differ with regard to their effect on exercise performance. Exercise performance ability, irrespective of exercise intensity and duration, is impaired to a greater extent following non-selective than beta 1-selective blockade at equal reductions in heart rate. This response stems from a decreased energy flux through glycogenolysis during non-selective blockade treatment. Individuals receiving beta-blockade medication therefore show greater adaptive response to physical conditioning during treatment with beta 1-selective than non-selective blockade probably because of greater training intensity with the former therapy. Neither psychomotor performance nor muscular strength and power is negatively affected by beta-blockade. Nevertheless, the ability to perform athletic events requiring high levels of motor control under emotional stress but not high levels of aerobic or anaerobic energy release, is probably increased during beta-blockade.
β-肾上腺素能受体阻滞剂（β受体阻滞剂）是治疗各种心血管疾病的常用一线药物。然而，在单剂量服用β受体阻滞剂期间进行体育锻炼，会导致自觉用力率增加；长期治疗后，这种效应似乎会部分减轻。尽管临床剂量的β受体阻滞剂可使心率降低30%至35%，但在最大运动时心输出量并不会同等程度降低。因此，大多数研究表明，β受体阻滞剂治疗后每搏输出量增加。心率降低通常伴随着患者和健康训练受试者的最大摄氧量降低（5%至15%）。与心输出量的降低相比，最大摄氧量的降低幅度较小，这是动静脉氧分压差部分代偿性增加的结果。β受体阻滞剂治疗后，反映进行剧烈短期或更持久稳态运动能力的工作能力也会受损。β-肾上腺素能受体可分为β1和β2型。对β1受体具有特异性的阻滞剂（β1选择性阻滞剂）或对β1和β2受体均有作用的阻滞剂（非选择性阻滞剂），在对运动表现的影响方面存在差异。在心率同等降低的情况下，非选择性阻滞剂比β1选择性阻滞剂更能损害运动表现能力，且与运动强度和持续时间无关。这种反应源于非选择性阻滞剂治疗期间糖原分解导致的能量通量降低。因此，接受β受体阻滞剂治疗的个体在使用β1选择性阻滞剂而非非选择性阻滞剂治疗期间，可能由于前者治疗强度更大，对体育锻炼的适应性反应更强。β受体阻滞剂对精神运动表现、肌肉力量和功率均无负面影响。然而，在情绪应激下进行需要高水平运动控制但不需要高水平有氧或无氧能量释放的体育赛事的能力，在β受体阻滞剂治疗期间可能会增强。
