Effects of atenolol on rest and exercise hemodynamics in patients with mitral stenosis

Stoll, Brett C.; Ashcom, Thomas L.; Johns, Joseph P.; Johnson, James E.; Rubal, Bernard J.

doi:10.1016/s0002-9149(99)80585-2

Cited by 30 publications

(11 citation statements)

References 11 publications

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“…The negative influence of acute BB administration on peak exercise performance has been previously described in healthy individuals, being more pronounced with nonselective than with A 1 -selective BB (60). In contrast, short-term (e1w k )B Ba d m i n i s t r a t i o nd o e st oa f f e c t incremental exercise time in HF patients, irrespective of type of BB (28,64,65). Similarly, in the present metaanalysis, peak exercise performance remained consistently unaltered after prolonged BB treatment.…”

Section: Discussioncontrasting

confidence: 51%

Effect of Beta-blocker Treatment on V˙O2peak in Patients with Heart Failure

Montero

Flammer

2018

Medicine &Amp; Science in Sports &Amp; Exercise

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Section: Discussioncontrasting

confidence: 51%

Effect of Beta-blocker Treatment on V˙O2peak in Patients with Heart Failure

Montero

Flammer

2018

Medicine &Amp; Science in Sports &Amp; Exercise

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“…Caso esse tempo seja diminuído pela metade, o gradiente pressórico transmitral irá quadruplicar, acarretando elevação da pressão venosa pulmonar. Os betabloqueadores, ao controlar a FC em repouso, são capazes de reduzir os gradientes e as pressões desenvolvidas pelo átrio esquerdo 37,38 .Adicionalmente, essa classe de agentes também possui a propriedade de estabilizar a FC durante a atividade física, atenuando o incremento fisiológico no gradiente pressórico mitral nessas circunstâncias 39 .…”

Section: Tratamento Farmacológicounclassified

Diretriz Brasileira de Valvopatias - SBC 2011/ I Diretriz Interamericana de Valvopatias - SIAC 2011

Tarasoutchi¹,

Montera²,

Grinberg³

et al. 2011

Arq. Bras. Cardiol.

126

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Os anúncios veiculados nesta edição são de exclusiva responsabilidade dos anunciantes, assim como os conceitos emitidos em artigos assinados são de exclusiva responsabilidade de seus autores, não refletindo necessariamente a opinião da SBC. Todos os direitos reservados e protegidos pela lei 9.610 de 19/02/98. Nenhuma parte desta publicação poderá ser reproduzida sem autorização prévia por escrito dos Editores, sejam quais forem os meio empregados: eletrônico, mecânico, fotográfico, gravação ou quaisquer outros. Material de distribuição exclusiva à classe médica. Os Arquivos Brasileiros de Cardiologia não se responsabilizam pelo acesso indevido a seu conteúdo e que contrarie a determinação em atendimento à Resolução da Diretoria Colegiada (RDC) nº 96/08 da Agência Nacional de Vigilância Sanitária (Anvisa), que atualiza o regulamento técnico sobre Propaganda, Publicidade, Promoção e informação de Medicamentos. Segundo o artigo 27 da insígnia, "a propaganda ou publicidade de medicamentos de venda sob prescrição deve ser restrita, única e exclusivamente, aos profissionais de saúde habilitados a prescrever ou dispensar tais produtos (...)". Garantindo o acesso universal, o conteúdo científico do periódico continua disponível para acesso gratuito e integral a todos os interessados no endereço: www.arquivosonline.com.br.

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“…HR control improves diastolic filling and prevents the rise of PCWP [ 18 ]. Several studies have demonstrated the value of beta-blockers in the hemodynamics and symptom improvement of MS [ 7 - 10 ]. In our study, we have shown that ivabradine was able to achieve a significantly lower maximal HR after exercise, compared to guideline-based HR controllers.…”

Section: Discussionmentioning

confidence: 99%

“…Beta-blockers have been shown in a number of trials to be effective as medical therapy in MS, though there are also conflicting data [ 7 - 10 ]. Another issue that besets beta-blockers in MS is the potential for adverse reactions, including fatigue, bronchoconstriction, AV blocks, depression, and intolerance [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Ivabradine Versus Beta-Blockers in Mitral Stenosis in Sinus Rhythm: An Updated Meta-Analysis of Randomized Controlled Trials

et al. 2018

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BackgroundSymptoms of mitral stenosis (MS) are worsened during tachycardia and exercise. Beta-blockers are used in controlling heart rate (HR) in MS, resulting in symptom improvement, but coming with significant side effects. Ivabradine has a selective action on the sinus node devoid of the usual side effects of beta-blockers. Small studies have recently investigated the role of ivabradine in MS in sinus rhythm. Our aim was to determine the efficacy of ivabradine, compared to beta-blockers, in terms of exercise duration, maximum HR achieved, resting HR, mean gradient, and working capacity among patients with MS in sinus rhythm.MethodsWe conducted a systematic search of studies using MEDLINE, Google Scholar, ScienceDirect, Scopus, Clinical Key, Cochrane, and clinicaltrials.gov databases in all languages and examined reference lists of studies. We included studies if they are: 1) randomized controlled trials comparing ivabradine and beta-blockers; 2) of adults ≥ 19 years old with MS in sinus rhythm; and 3) reported data on exercise duration, maximum HR achieved, resting HR, mean gradient, and working capacity. Studies identified were assessed for risk of bias using the Cochrane Collaboration Tool for Assessing Risk of Bias. We used inverse variance analysis of fixed effects to compute for mean difference, carried out using Review Manager (RevMan) 5.3.ResultsPooled analysis from five identified trials showed that among patients with MS in sinus rhythm, ivabradine was better compared to beta-blockers in total exercise duration (mean difference: 32.73 s (95% CI: 12.19, 53.27; P = 0.002; I2 = 0%)), maximum HR achieved after exercise (mean difference: -3.87 beats per minute (95% CI: -5.88, -1.860; P = 0.0002; I2 = 23%)), and work capacity (mean difference: 0.56 METS (95% CI: 0.33, 0.80; P < 0.00001; I2 = 0%)); inferior to beta-blockers in resting HR achieved (mean difference: 1.83 s (95% CI: 0.39, 3.28; P = 0.01; I2 = 91%)); and comparable to beta-blockers in terms of mean gradient (mean difference: -0.52 mm Hg (95% CI: -1.20, 0.16; P = 0.13; I2 = 6%)).ConclusionsIvabradine is better or comparable to beta-blockers in terms of the outcomes measured, and may be considered as an alternative for patients with MS in sinus rhythm who are intolerant to beta-blockers.

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Effects of atenolol on rest and exercise hemodynamics in patients with mitral stenosis

Cited by 30 publications

References 11 publications

Effect of Beta-blocker Treatment on V˙O2peak in Patients with Heart Failure

Effect of Beta-blocker Treatment on V˙O2peak in Patients with Heart Failure

Diretriz Brasileira de Valvopatias - SBC 2011/ I Diretriz Interamericana de Valvopatias - SIAC 2011

Ivabradine Versus Beta-Blockers in Mitral Stenosis in Sinus Rhythm: An Updated Meta-Analysis of Randomized Controlled Trials

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