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PubMed2003

Assessment of anti-ischemic and antianginal effect at trough plasma concentration and safety of trimetazidine MR 35 mg in patients with stable angina pectoris: a multicenter, double-blind, placebo-controlled study.

OBJECTIVE: The study aimed to assess, at trough plasma concentration, the anti-ischemic and antianginal efficacy and tolerability of trimetazidine modified release (MR) 35 mg taken twice daily by patients with stable angina pectoris. DESIGN: This multicenter, randomized, double-blind, placebo-controlled, international study started with a run-in period of 3 weeks with atenolol 50 mg/day and placebo, followed by a 6-month treatment period with once daily atenolol 50 mg and twice daily trimetazidine MR 35 mg or placebo. PATIENTS: The study involved 223 patients with stable angina pectoris (class II or III of the Canadian Cardiovascular Society [CCS] classification). 180 patients were analyzed in the full analysis set (FAS) following the intention to treat principle (ITT) and 167 patients were analyzed in the per protocol set (PPS). The PPS data are presented here. INTERVENTIONS: Two exercise tolerance tests (ETTs) were performed during the run-in period in order to assess the stability of exercise tolerance before angina pectoris and significant ST segment depression. Efficacy was assessed by a third ETT performed after 8 weeks of treatment, at trough, 12 hours after the intake of the drug. Safety was evaluated over the 6-month duration of the study. MAIN OUTCOMES MEASURES: Time to 1 mm ST segment depression. RESULTS: Time to 1 mm ST segment depression was increased by 44 seconds more in the trimetazidine MR 35 mg group than in the placebo group (p = 0.005). A significant difference was also evidenced for the time to onset of angina pectoris (p = 0.049) and for the reason for stopping the exercise (p = 0.02). No difference between groups was found for safety parameters. CONCLUSION: This study demonstrates the anti-ischemic and antianginal efficacy of trimetazidine MR 35 mg twice daily at trough plasma concentrations in patients with stable angina pectoris receiving atenolol 50 mg/day. Furthermore, the drug is well tolerated over 6 months.

Administration, Oral↗

PubMed1992

Biochemical and physiological parameters and estimated work output in draught horses pulling loads for long periods.

A study was undertaken in five draught horses of 648 +/- 33 kg body weight to find the effects of continuously pulling loads on their cardiovascular, respiratory and metabolic responses. A cart equipped with an odometer, for measuring distance, and a hydraulic dynamometer, for measuring draught force, was used. Heart and respiration rates and rectal temperatures were recorded. Blood samples for measuring arterial and venous pH and blood gases, haemoglobin, glucose and lactic acid concentrations and the serum activity of the enzymes creatine phosphokinase (CK), lactate dehydrogenase, aspartate aminotransferase and alkaline phosphatase were taken before exercise and immediately after each journey (morning and afternoon) of the daily work. Draught exercise, with loads which generated forces of between 0.57 and 0.59 kN, at speeds of 1.60 to 2.11 m/s, for 8 h daily for five consecutive days, with resting intervals of 10 min each hour, was well tolerated. Exercise tolerance was evaluated from the recovery from the changes observed in the biochemical and physiological parameters induced by the work. The analysis of these showed that, when the horses were subjected to prolonged periods of resting, their loss of fitness for work was shown by significant increases in the serum activity of muscle-derived enzymes and in blood lactate concentrations during the first day of work. However, over the following days the horses adapted to the work, so that the decreases in serum enzyme activities and blood lactate concentrations were reduced. Since similar observations have been described for racehorses, the determination of blood lactate concentrations and the serum activities of muscle-derived enzymes, specifically CK, seem to be good indicators of fitness in draught horses.

Acid-Base Equilibrium↗

PubMed1996

Clinical benefit of angiotensin-converting enzyme inhibitors in chronic heart failure.

The ideal therapy for patients with chronic heart failure should reduce symptoms related to pulmonary congestion or low perfusion, prevent the progression of left ventricular dysfunction and, ultimately, should reduce mortality. Extensive studies in humans have investigated the effects of angiotensin-converting enzyme (ACE) inhibitors on these goals of therapy. As an example, the ACE inhibitor cilazapril significantly improved exercise tolerance, as borne out by a meta-analysis of six placebo-controlled, randomized 3-month trials. Comparison of the effects of cilazapril and captopril vs. placebo in one of the trials documented similar improvement in exercise tolerance (14 vs. 17%). Results from other randomized comparative trials suggest that the improvement in symptoms represents a class effect of ACE inhibitors. A beneficial effect of ACE inhibition on the progression of left ventricular dysfunction has also been demonstrated in the SOLVD trial, and a reduction of mortality has been amply documented in several mortality trials (CONSENSUS I, SOLVD, V-HeFT-II, SAVE, AIRE, SMILE) in patients with or without preceding myocardial infarction. Reports that ACE inhibitors also reduce the incidence of reinfarction after myocardial infarction have not been confirmed in all studies but raise the interesting concept that ACE inhibition may interact, in a beneficial but thus far not well-understood way, with key processes in the development of atherosclerosis, thereby preventing plaque rupture, thrombus formation, and myocardial infarction. Taken together, a large database convincingly demonstrates that ACE inhibitors are effective not only in improving symptoms but also in the prevention of progression of left ventricular dysfunction, in the reduction of mortality, and possibly in stabilizing the atherosclerotic disease process.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2001

Pulmonary rehabilitation in outpatients with asthma or chronic obstructive lung disease. A pilot study of a "modular" rehabilitation programme.

STUDY/PRINCIPLES: Pulmonary rehabilitation programmes are often costly and dependent on the infrastructure of specialised centres. We developed a modular, outpatient-based rehabilitation programme, which is inexpensive and can be implemented in a variety of settings. The aim of this study was to determine the effects and feasibility of this programme. METHODS: Thirteen patients with COPD and 7 patients with asthma were enrolled by their primary care physician because of dyspnoea. Initial assessment included cardiopulmonary exercise testing, six-minute walking distance, lung function testing and multiple questionnaires addressing dyspnoea, depression and quality of life issues. The training consisted of 36 sessions of high intensity training of 2 hours duration to improve exercise tolerance, including 30 minutes of stationary cycling at the anaerobic threshold. Another complete assessment was done on completion of the study at 3 months. RESULTS: The six-minute walking distance improved significantly from 401 to 551 m (p < 0.0001). The maximal exercise capacity increased significantly from 85 W to 99 W (p < 0.001). The anaerobic threshold remained unchanged despite the high intensity training. There was a reduction of dyspnoea and an improvement of quality of life. CONCLUSION: This study shows that our outpatient rehabilitation programme leads to a benefit in exercise tolerance and health related quality of life comparable to other programmes published in the literature. The rehabilitation programme was very well accepted among patients, primary care physicians and health insurers.

Adult↗

PubMed1991

Differences in the antiischaemic effects of molsidomine and isosorbide dinitrate (ISDN) during acute and short-term administration in stable angina pectoris.

The acute and short-term effects of treatment with 10 consecutive doses of isosorbide dinitrate 40 mg t.i.d. and molsidomine 8 mg t.i.d. in slow release formulations were investigated in 10 patients with angiographically documented coronary artery disease and stable angina pectoris according to a randomized, double-blind, double-dummy, cross-over study design using conventional symptom-limited exercise testing. Acute exercise testing 3 h following the first dose of ISDN and molsidomine showed a significant reduction of maximal ST segment depression and of the area above the ST segments. Time to occurrence of 0.1 mV ST segment depression, exercise duration, time to onset of angina and exercise tolerance increased significantly. On the fourth treatment day with ISDN and molsidomine an attenuation of these antiischaemic effects was seen. The mean effects on ST segment depression, area above ST segments, time to occurrence of 0.1 mV ST segment depression, exercise duration, time to onset of angina and exercise tolerance were reduced by 40%, 44%, 47%, 58%, 54% and 65%, respectively, in patients administered ISDN and by 33%, 48%, 58%, 59%, 45% and 60% in those given molsidomine. Thus, following sustained short-term therapy the antiischaemic effects of both drugs seem to be attenuated. In this report no marked differences were found between ISDN and molsidomine.

Angina Pectoris↗

PubMed1998

Benefits of exercise training in patients on continuous ambulatory peritoneal dialysis.

We examined the effects of a 12-week exercise program on the exercise tolerance, blood biochemistry, blood pressure (BP) control, cardiac function, and quality-of-life (QOL) scores in 13 patients undergoing continuous ambulatory peritoneal dialysis (CAPD; six men, seven women; mean age, 46.5+/-12.8 years; mean duration on dialysis, 4.8+/-3.8 years). The patients underwent exercise training on treadmill, bike, and arm ergometers thrice weekly. Seven CAPD patients matched for age, sex, and duration on dialysis served as controls. The mean peak aerobic capacity (VO2peak) of the exercisers increased by 16.2% after training (pre- and postexercise, 17.2+/-5.2 v 20.0+/-6.4 mL/kg/min; P=0.004). Although there were no significant changes in serum urea, creatinine, albumin, and hematocrit levels; left ventricular diastolic/systolic diameters; and ejection fraction, an increasing trend of high-density lipoproteins (HDLs) was observed in the exercisers (baseline v postexercise, 33+/-11 v 40+/-14 mg/dL; P=0.06). Twenty-four-hour ambulatory BP monitoring showed a significant increase in daytime systolic BP in the exercisers (pre- and postexercise, 142+/-26 v 157+/-22 mm Hg; P=0.003), but no significant changes could be found in the ambulatory daytime diastolic BP, nocturnal BP, and resting clinic BP. The patients' QOL improved after training, with better scores in two Kidney Disease Quality of Life scales (KDQOL): burden of kidney disease and physical functioning. Two mild and uncomplicated hypotensive episodes were reported in two patients immediately after training. No changes occurred in exercise capacity, blood biochemistry, BP profile, and QOL scores in the controls. We conclude that structured aerobic exercise is safe and can improve the exercise tolerance and QOL outcomes in CAPD patients.

Adult↗

PubMed1985

Oral labetalol in the management of stable angina pectoris in normotensive patients.

The efficacy of labetalol, an alpha and beta receptor antagonist, was evaluated in 12 normotensive patients with stable angina pectoris in a single blind dose ranging study. After a two week period of placebo treatment, labetalol was given in doses of 100, 150, 200, and 300 mg twice daily, each for two weeks. Frequency of angina attacks decreased from 9.4 (SEM 2.3)/week in the control period to 7.3 (2.8), 5.2 (2.6), 3.8 (1.8), and 3.3 (1.9)/week in the four successive treatment periods. In the same periods the number of glyceryl trinitrate tablets consumed decreased from 7.0 (2.6)/week to 5.8 (3.3), 3.9 (2.9), 2.7 (1.8), and 2.6 (2.1)/week. Maximal symptom limited treadmill exercise tests were performed three and 12 hours after dosage at each dose. Exercise tolerance (expressed as seconds of the Bruce protocol) increased from 266 (44) with placebo to 306 (44), 369 (50), 396 (48), and 413 (51) in the four treatment periods. This improvement was accompanied by a significant blunting of the heart rate and blood pressure responses to exercise. Trough point exercise tolerance did not differ significantly from that at three hours after dosage. Thus labetalol is effective as an antianginal agent at doses of 150-300 mg twice daily and is well tolerated by the normotensive patient with angina.

Adult↗

PubMed1985

Physiological versus single-rate ventricular pacing: a double-blind cross-over study.

Previous comparisons of physiological and single-rate ventricular pacing are mostly based on open studies. The present investigation was designed to control possible biases of such a study design with the aim to investigate effects of the two pacing modes on maximal and submaximal exercise tolerance and the subjective feeling of well-being of the patients. Forty-four patients treated with atrioventricular synchronous pacemakers for more than 12 months participated in the study. Their pacemakers were randomly programmed to one 3-week long period of ventricular inhibited and a similar period of atrioventricular synchronous ventricular inhibited pacing. Thereafter, they went through echocardiography, symptom-limited maximal exercise test and answered a questionnaire on subjective symptoms. The study was blind since neither the patients nor the physician conducting the exercise tests were informed of pacing mode. The mean maximal exercise tolerance increased 14% (p less than 0.01) on atrioventricular synchronous pacing. Arterial lactate, respiratory rates and perceived exertion ratings during submaximal levels of exercise were higher on ventricular inhibited pacing, as well as symptoms scored during the two 3-week periods. A majority of patients improved their functional class during atrioventricular synchronous pacing and preferred the physiological pacing mode.

Adolescent↗

PubMed1994

Effect of sustained release diltiazem (Diltiazem-R) in patients with stable effort angina.

Ca++-antagonist is effective not only for variant angina but also for effort angina. The effects of sustained release diltiazem (diltiazem-R) and beta 1-blocker (atenolol) on exercise tolerance were studied in seven patients with stable effort angina in a cross over trial. Diltiazem-R (100mg) or atenolol (50mg) was given once a day, each treatment period lasting for two weeks after a two-week control period. The treadmill exercise test was performed on the last day of each protocol. Both diltiazem-R and atenolol decreased heart rate at rest and the decrease with atenolol was greater than that with diltiazem-R. The systolic blood pressure was unchanged at rest by both drugs. At maximal work levels, atenolol decreased the heart rate and pressure rate product significantly but diltiazem-R did not. Both diltiazem-R and atenolol significantly prolonged the exercise time (average 137 and 165 seconds respectively), time to onset of 1mm ST depression (240 and 288 seconds respectively). There was no significant difference in exercise tolerance between diltiazem-R and atenolol. These findings suggest that diltiazem-R, a sustained release Ca++-antagonist, provides beneficial effects in patients with stable effort angina.

Angina Pectoris↗

PubMed1997

Overview of the treatment of heart failure.

Short-term goals of heart failure management are directed toward relieving symptoms such as shortness of breath, decreased exercise tolerance, and lower-extremity edema and improving functional capacity and quality of life. Long-term goals include decreasing mortality and slowing or reversing the underlying cardiac structural abnormalities of heart failure. Improvement in symptomatic endpoints (e.g., exercise tolerance) does not necessarily correlate with endpoints for improved survival (e.g., left ventricular ejection fraction). It is therefore important to evaluate the effects of drugs on these distinct endpoints separately. Symptoms of heart failure are commonly managed with the use of diuretics, vasodilators, and positive inotropes or digoxin. Ideally, therapy should consist of a diuretic plus vasodilator (e.g., angiotensin-converting enzyme [ACE] inhibitor or isosorbide dinitrate plus hydralazine), with or without digoxin. Prevention of further left ventricular dysfunction can be accomplished by inhibiting neurohormonal processes and ventricular remodeling that occur in heart failure using ACE inhibitors, nitrates and hydralazine, or beta blockers. Significant therapeutic advances have been made with respect to symptom relief, hospitalizations, and mortality reduction in patients with congestive heart failure. Despite these advances, patient morbidity and mortality remain high and underscore the necessity for optimal use of existing therapies along with research directed at achieving further improvements in both quality of life and life expectancy.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2005

Preoperative cardiovascular evaluation for noncardiac surgery.

Cardiovascular complications following noncardiac surgery constitute an enormous burden of perioperative morbidity and mortality. Annually, more than one million operations are complicated by adverse cardiovascular events, such as perioperative myocardial infarction or death from cardiac causes. In order to combat this problem, cardiac evaluation prior to noncardiac surgery should ask two questions about the patient: What is the risk of cardiac complications during and after surgery? How can that risk be reduced or eliminated? Risk assessment evaluates patients' co-morbidities and exercise tolerance, as well as the type of surgery to be performed, to determine the overall risk of perioperative cardiac complications. Previous or current cardiac disease, diabetes and renal insufficiency all confer higher risks for perioperative cardiac complications. Poor exercise tolerance and high-risk surgical procedures (e.g., vascular, prolonged thoracic or abdominal operations) also predict worse perioperative outcomes. Noninvasive stress testing is widely used to help predict risk of perioperative complications, but the poor predictive power of these tests hampers their usefulness. After estimating the risk of cardiac complications, one should take measures to reduce it. Beta blockade has shown clear benefits in risk reduction. At this time, there are no data suggesting benefits of percutaneous coronary intervention or coronary artery bypass grafting in reducing noncardiac surgical risk. In addition, angioplasty with stenting and its attendant need for anticoagulation can expose patients to increased risk of perioperative bleeding. Thus, the use of coronary revascularization prior to noncardiac surgery should be reserved for those patients with an independent cardiac need for the procedure, such as unstable angina or stable angina refractory to medical therapy. In summary, patients with low clinical risk factors and good functional status, undergoing a low or intermediate risk surgery, have an excellent prognosis and may proceed to surgery without further delay. In addition, stable patients who have previously undergone coronary revascularization may also safely undergo surgery. Patients requiring urgent surgery should proceed immediately, since the consequences of delay usually outweigh the benefits of preoperative risk assessment. However, elective surgery should be indefinitely deferred for those patients with unstable coronary syndromes, since consequences of the cardiac disease usually negate the benefits of surgery. Controversy involves the intermediate or high clinical risk patient considering high-risk, but elective, surgery. Noninvasive testing offers only limited assistance in estimating risk for these patients. The best risk reduction strategy for these patients is perioperative beta blockade use. The role of coronary revascularization specifically to reduce perioperative cardiac complications remains unproven.

Cardiovascular Diseases↗

PubMed2005

Respiratory muscle training in chronic obstructive pulmonary disease: inspiratory, expiratory, or both?

PURPOSE OF REVIEW: Most patients with significant chronic obstructive pulmonary disease (COPD) have inspiratory and expiratory muscle weakness. In addition, hyperinflation induces functional weakening of the inspiratory muscles, increased elastic load to breathing, and intrinsic positive end expiratory pressure (PEEPi). Therefore, it was rational to expect that patients with COPD would benefit from specific inspiratory or expiratory muscle training (SIMT, SEMT respectively). However, the functional benefits of SIMT have remained equivocal. In recent years, a number of studies have demonstrated that, when training loads are controlled, SIMT results in important functional benefits. The role of SEMT is still unclear. RECENT FINDINGS: Well-controlled SIMT in patients with COPD leads to relief of dyspnea, during both daily activities and during physical activity. This yields increased exercise tolerance, and thus the capacity to walk, improving health related quality of life. We argue that there is now evidence that SIMT is an important addition to pulmonary rehabilitation programs for patients with COPD. Although two recent studies have shown that SEMT also provides a beneficial effect in patients with COPD, this does not appear to be supplementary to the effect to SIMT. SUMMARY: Inspiratory and expiratory muscles can be specifically trained yielding improvements in both strength and endurance. The improvement in inspiratory muscle performance is associated with an improvement in the sensation of dyspnea, exercise tolerance, and quality of life. When the expiratory muscles are specifically trained, a significant increase in exercise performance has also been shown. However, there is probably no additional benefit in combining SEMT with SIMT.

Breathing Exercises↗

PubMed1990

Acute and chronic effects of a diuretic monotherapy with piretanide in congestive heart failure--a placebo-controlled trial.

To evaluate the acute and chronic effects of diuretic monotherapy with 3 mg piretanide bid, 46 patients (pts) with congestive heart failure (NYHA II-III) secondary to coronary artery disease were studied. Within 3 weeks of therapy, the patients lost 1.6 kg body weight. Forty-four patients reported a subjective feeling of improvement. Echocardiographically, a highly significant (p less than 0.001) reduction of diastolic and systolic diameters was found, as well as an increase of fraction shortening. Chest x-ray indicated a reduction of heart volume from 1012 +/- 263 ml to 936 +/- 233 ml (p less than 0.001). The serum potassium level remained unchanged. A subgroup of 26 pts underwent invasive hemodynamic examinations. IV injection of 6 mg piretanide resulted in an acute reduction of pulmonary wedge pressure (pc) from 20.2 +/- 5.3 mmHg to 11.9 +/- 5.0 mmHg (p less than 0.001); simultaneously a slight decrease of cardiac index from 3.2 +/- 0.6 l/min/m2 to 3.0 +/- 0.4 l/min/m2 was observed. Invasive control after 3 weeks of oral therapy showed no decline of the piretanide effect. The exercise tolerance increased clearly from 135 +/- 161 Wmin to 249 +/- 268 Wmin (p less than 0.05). A control group of further 14 pts was treated with placebo only and did not show any significant changes of pc (20.0 +/- 6.4 mmHg vs. 22.8 +/- 19.2 mmHg), exercise tolerance, or other clinical parameters. Thus, the diuretic monotherapy of congestive heart failure with piretanide is highly effective and shows a significant improvement in all clinical and hemodynamic parameters in the absence of any remarkable side effects.

Adult↗

PubMedDate not supplied

Determinants of exercise blood pressure response in normotensive and hypertensive women: role of cardiorespiratory fitness.

PURPOSE: Exaggerated blood pressure (BP) response during physical exertion is associated with increased risk for cardiovascular events. Furthermore, it may be the predisposing factor for myocardial infarction triggered by physical exertion. The authors have shown that systolic BP achieved after 6 minutes of exercise is the strongest predictor of left ventricular hypertrophy. Furthermore, a 37 mm Hg increase in systolic BP above resting BP at 6 minutes of exercise was the threshold for left ventricular hypertrophy. The purpose of this study was to determine predictors of exercise BP response in normotensive and hypertensive women. METHODS: An exercise tolerance test (Bruce) was performed by 1411 normotensive (resting BP < 140/90 mm Hg) and hypertensive (resting BP > or = 140/90 mm Hg) women. These women were faculty, students, and staff at the University of Maryland, College Park, Maryland, and the George Washington University Medical Center, as well as patients undergoing a routine exercise tolerance test at West Coast Cardiology, Pinellas Park, Florida. Two fitness categories (low-fit and high-fit) were established on the basis of treadmill time to exhaustion adjusted for age. RESULTS: Significant associations were observed among the 6-minute exercise BP and age, body mass index, resting systolic and diastolic BP, heart rate, and exercise time to exhaustion. In a stepwise multiple-regression analysis, the determinants of BP after 6 minutes of exercise were resting systolic BP and treadmill time to exhaustion (R2 = 0.36) for normotensive women and treadmill time to exhaustion and resting systolic BP (R2 = 0.30) for hypertensive women. When fitness categories were contrasted, low-fit women in both the normotensive and hypertensive categories had higher BP and rate-pressure product after 6 minutes of exercise than the high-fit women (P <.05). CONCLUSIONS: Resting systolic BP and cardiorespiratory fitness are determinants of a submaximal exercise BP response for both hypertensive and normotensive women. Low cardiorespiratory fitness is associated with a higher BP response during submaximal exercise, suggesting that increased fitness may attenuate this abnormal rise in BP. Thus, low- to moderate-intensity physical activities for most days of the week should be encouraged for all women to increase cardiorespiratory fitness. This is likely to attenuate an abnormal rise in systolic BP that may occur during routine daily activities and protect against the associated health consequences.

Adult↗

PubMed1990

Heart failure with normal ejection fraction. The V-HeFT Study. Veterans Administration Cooperative Study Group.

In patients with clinical heart failure entered into the Veterans Administration Cooperative Study (V-HeFT) trial, 83 of 623 who had a baseline radionuclide measurement of left ventricular ejection fraction exhibited an ejection fraction of at least 0.45. When compared with the patients with an ejection fraction of less than 0.45, these subjects with apparent predominant diastolic dysfunction had a lower incidence of coronary artery disease (26.5% vs. 47.2%, p less than 0.001) and a higher incidence of preexisting hypertension (53.0% vs. 39.4%, p less than 0.02). In the normal ejection fraction group, systolic blood pressure was higher (129.7 vs. 117.7 mm Hg, p = 0.0001), heart rate slower (75.0 vs. 83.2 beats/min, p = 0.0001), cardiothoracic ratio smaller (0.512 vs. 0.536, p = 0.002), echocardiographic left ventricular dimension smaller in diastole (61.7 vs. 69.2 mm, p = 0.0001) and in systole (47.4 vs. 58.1 mm, p = 0.0001), and posterior wall thickness greater (9.0 vs. 7.9 mm, p = 0.004). Exercise tolerance was only slightly better in the normal ejection fraction group (peak oxygen consumption, 15.5 vs. 14.6 ml/kg/min, p = 0.04). Prognosis in the normal ejection fraction patients (annual mortality rate, 8.0%) was significantly better than in the low ejection fraction group (annual mortality rate, 19.0%) (p = 0.0001). Ventricular tachycardia on Holter monitor was a poor prognostic sign in these patients, and severe reduction in exercise tolerance also tended to predict poor outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Exercise Test↗

PubMedDate not supplied

Cardiovascular conditioning in individuals with diabetic retinopathy.

The benefit of exercise for individuals with diabetes mellitus and high-risk complications of retinopathy has been questioned. Thirty-nine individuals with diabetes and visual impairment completed a 12-wk rehabilitation program that included cardiovascular conditioning. Pre- and postprogram assessment of exercise training in 30 subjects included a graded stress test with a bicycle ergometer. There were improvements in exercise tolerance as measured by the work load achieved (from 248 +/- 27 to 303 +/- 31 kilopond meter [kpm], P less than .05). There was a trend toward improvement in METS achieved (from 3.3 +/- 0.2 to 3.8 +/- 0.3, P = .06). There was no correlation of improvement in exercise tolerance with improvements in glycemic control, lipoprotein balance, and change in body weight. Individuals with diabetic retinopathy may be given the option of entering cardiovascular training programs with appropriate modifications to fit specific needs.

Adult↗

PubMed1989

[Exercise testing of the chronic effects of bunazosin hydrochloride on dilated cardiomyopathy].

Bunazosin hydrochloride was administrated in 3-mg oral doses to the 10 patients (6 males and 4 females, average 49.9 years) with dilated cardiomyopathy (DCM) of class II in the NYHA functional classification. Then we observed the changes in their hemodynamics at rest, chest X-ray, echocardiography, humoral factors and symptom-limited exercise tolerance with treadmill testing before treatment and 4 and 8 weeks after administration. All but the left ventricular end-diastolic diameter after 8 weeks were unchanged. Of the humoral factors, only aldosterone decreased significantly during the treatment. On the other hand, the duration of symptom-limited exercise was prolonged significantly, and for a given exercise load, a reduction of heart rate and systolic blood pressure as well as a drop in the PRP occurred at 8 weeks after administration. Therefore, bunazosin appears to improve cardiac function and exercise tolerance in the patients with DCM, at dosages which do not affect hemodynamics at rest.

Adolescent↗

PubMed1989

Exercise testing of the chronic effects of bunazosin hydrochloride on dilated cardiomyopathy.

Bunazosin hydrochloride (Detantol) was administrated in 3-mg oral doses to 10 patients (6 males and 4 females, average 49.9 years) with dilated cardiomyopathy (DCM) of class II in the NYHA functional classification. The patients were observed for changes in their hemodynamics at rest, chest X-ray, echocardiography, humoral factors and symptom-limited exercise tolerance with treadmill testing before treatment and 4 and 8 weeks after administration. All but the left ventricular end-diastolic diameter after 8 weeks were unchanged. Of the humoral factors, only aldosterone decreased significantly during the treatment. On the other hand, the duration of symptom-limited exercise was prolonged significantly, and for a given exercise load, a reduction of heart rate and systolic blood pressure as well as a drop in the pressure-rate product occurred at 8 weeks after administration. Therefore, bunazosin appears to improve cardiac function and exercise tolerance in the patients with DCM, at dosages which do not affect hemodynamics at rest.

Adolescent↗