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Exercise training reduces sympathetic nerve activity in heart failure patients treated with carvedilol
Author(s) -
Fraga Raffael,
Franco Fábio G.,
Roveda Fabiana,
Matos Lucia.J.,
Braga Ana M.F.W.,
Rondon Maria U.P.B.,
Rotta Daniel R.,
Brum Patricia C.,
Barretto Antonio C.P.,
Middlekauff Holly R.,
Negrão Carlos E.
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2007.03.003
Subject(s) - carvedilol , medicine , heart failure , microneurography , cardiology , forearm , vascular resistance , hemodynamics , heart rate , anesthesia , blood pressure , surgery , baroreflex
Background: Evidence suggests that carvedilol decreases muscle sympathetic nerve activity (MSNA) in patients with heart failure (HF) but carvedilol fails to improve forearm vascular resistance and overall functional capacity. Exercise training in HF reduces MSNA and improves forearm vascular resistance and functional capacity. Aims: To investigate whether the beneficial effects exercise training on MSNA are maintained in the presence of carvedilol. Methods and results: Twenty seven HF patients, NYHA Class II–III, EF <35%, peak VO 2 <20 ml/kg/min, treated with carvedilol were randomly divided into two groups: exercise training ( n =15) and untrained ( n =12). MSNA was recorded by microneurography. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. The four‐month training program consisted of three 60‐min exercise/week on a cycloergometer. Baseline parameters were similar between groups. Exercise training reduced MSNA (–14±3.3 bursts/100 HB, p =0.001) and increased forearm blood flow (0.6±0.1 mL/min/100 g.p p >0.001) in HF patients on carvedilol. In addition, exercise training improved peak VO 2 in HF patients (20±6%, p =0.002). MSNA, FBF and peak VO 2 were unchanged in untrained HF patients on carvedilol. Conclusion: Exercise training reduces MSNA in heart failure patients treated with carvedilol. In addition, the beneficial effects of exercise training on muscle blood flow and functional capacity are still realized in patients on carvedilol.