Effect of beta-blockade on autonomic modulation of heart rate and neurohormonal profile in decompensated heart failure

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
D Aronson, A J Burger

Abstract

One of the putative mechanisms for the salutary effects of beta-blockers in patients with congestive heart failure (CHF) is their ability to improve autonomic dysfunction. However, patients with profound neurohumoral abnormalities derive little survival benefit from beta-blockers. The purpose of the current study was to evaluate the effect of beta-blockers on heart rate variability (HRV) in decompensated CHF. Time and frequency domain HRV indices were obtained from 24-hour Holter recordings and compared to assess the role of beta-blockade in 199 patients (mean age 60 +/- 14 years) with decompensated CHF. Neurohormonal differences were assessed by measuring norepinephrine, endothelin-1, tumor necrosis factor-alpha, and interleukin-6 in a subset of 64 patients. All HRV indices were markedly suppressed but were substantially higher in patients who were on beta-blockers. Time domain measures of parasympathetic cardiac activity, the percentage of R-R intervals with > 50 ms variation (4.9 +/- 0.6 vs 7.7 +/- 1.2%, P = 0.006) and the square root of mean squared differences of successive R-R intervals (22.7 +/- 2.0 vs 31.6 +/- 4.1 ms, P = 0.004), were higher in the beta-blocker group. Spectral analysis revealed that the total power and ...Continue Reading

References

Dec 15, 1990·The American Journal of Cardiology·J N RottmanJ L Fleiss
Mar 31, 1989·Journal of Immunological Methods·N SuzukiM Fujino
Feb 1, 1973·Circulation Research·P J SchwartzA M Brown
Sep 27, 1984·The New England Journal of Medicine·J N CohnT Rector
Feb 1, 1995·Journal of the American College of Cardiology·H KrumM Packer
Mar 1, 1995·Circulation·K Yamauchi-TakiharaT Kishimoto
Apr 1, 1994·Circulation·C M WeiJ C Burnett
May 1, 1994·Journal of the American College of Cardiology·M J NiemeläH V Huikuri
Oct 1, 1993·Journal of the American College of Cardiology·J S Floras
Mar 15, 1996·The American Journal of Cardiology·F PoussetJ Y Le Heuzey
Oct 8, 1997·Journal of the American College of Cardiology·L FauchierJ P Fauchier

❮ Previous
Next ❯

Citations

Aug 25, 2006·Current Heart Failure Reports·Rami Alharethi, Ray E Hershberger
Jun 1, 2012·Journal of Caffeine Research·Catherine F Notarius, John S Floras
Sep 27, 2005·The Heart Surgery Forum·Nader Moazami, Mehmet C Oz
Apr 14, 2009·Heart Failure Reviews·Biykem BozkurtAnita Deswal
Oct 7, 2010·Heart Failure Reviews·Monali Y DesaiPaul J Hauptman
Nov 17, 2009·Toxicology Letters·Chien-Hua HuangWen-Jone Chen
Aug 29, 2007·Heart Failure Clinics·Johannes Mueller, Gerd Wallukat
Apr 30, 2005·Congestive Heart Failure·William T AbrahamUNKNOWN Vasodilation in the Management of Acute Congestive Heart Failure (VMAC) Study Group
Jun 26, 2012·Journal of Diabetes·Henri K ParsonAaron I Vinik
Oct 20, 2010·Hemodialysis International·Smrita DorairajanMadhukar Misra
Nov 6, 2015·BioMed Research International·Margarita KuninDganit Dinour
Nov 28, 2013·Clinical Science·Philip J Millar, John S Floras
Dec 12, 2017·Critical Care Medicine·Sarah J BeesleySamuel M Brown
Aug 21, 2018·Pilot and Feasibility Studies·Samuel M BrownUNKNOWN Esmolol to Control Adrenergic Storm in Septic Shock-ROLL-IN (ECASSS-R) study
Feb 23, 2019·Frontiers in Medicine·Robert L Drury, Scott A Simonetti

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antiarrhythmic Agents: Mechanisms of Action

Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Related Papers

The Medical Journal of Australia
W J LouisH Krum
La semaine des hôpitaux : organe fondé par l'Association d'enseignement médical des hôpitaux de Paris
J F Giudicelli, S Witchitz
Revue médicale de Liège
H Kulbertus
© 2021 Meta ULC. All rights reserved