The authors describe the use of milrinone as a bridge to beta blockade in a patient with severe heart failure. This case is clinically important because in patients with severe heart failure phosphodiesterase inhibitors, unlike beta agonists, will retain their positive inotropic and vasodilator effects in the presence of beta blockade and, in addition, these agents will attenuate the negative inotropic side effects of beta blockers. Conversely, a beta blocker associated with a phosphodiesterase inhibitor will protect against myocyte loss and arrhythmias, may prevent sudden death, and will improve long-term symptoms and exercise tolerance. This combination is being investigated in a large, multicenter, double-blind, randomized trial of intravenous milrinone vs. placebo as a therapeutic tool to allow the initiation of carvedilol orally in patients hospitalized with class III/IV heart failure. (c)2000 by CHF, Inc.
Background and Study Aim. The main focus of the study was to examine the effect of varied packages of plyometric training on speed, leg explosive power, and muscular endurance among university students. Material and Methods. Sixty subjects (age= 21.37+1.40) were divided into two groups namely, Control Group (CG, n=15) and Experimental Group (EG, n=45). The EG was further divided into three different groups based on the different training packages such as Low, Medium, and High-Intensity plyometric training. The .05 level of confidence was fixed as the level of significance to test the ‘F’ ratio obtained by the analysis of covariance, which was considered as appropriate. Plyometric training for a period of eight weeks offered to the participants of the Experimental Group. Results. The results revealed that various plyometric training programs have produced significant development in improving motor ability components such as speed, leg explosive power, and muscular endurance of the participants (p<.05). The results indicated that high-intensity plyometric training was noticed as superior then low and medium intensity plyometric training in the perspective of the effect of varied packages of plyometric on selected motor ability components among participants. Conclusion. Keeping in view the utility and importance of plyometric training, we recommended that the exercise protocol used in this study may helpful for the development and improvement of such components to get peak performance in sports.
Abbreviations: BFR, blood flow restriction; SKU, standard kaatsu unite; ACSM, american college of sports medicine; 1RM, one repetition maximum; VO 2max , maximal oxygen uptake IntroductionIn 1966, Sato Y received the inspiration of KAATSU. He felt numbness because of his sitting position on the floor. He recognized that pain is the same if the person did any resistance exercises. He attributed that swelling sensation to the decrease of blood flow and theorized that muscle swelling and altered sensation may be caused by, or associated with reduced blood flow to the muscle.1 Thus, reducing the amount of arterial blood flow to the working muscles while simultaneously moderate restriction return of venous blood flow is a form of training traditionally known as KAATSU which means in Japanese with (additional pressure). 2KAATSU training became an important training strategy which can increase muscle mass, endurance, and strength. (BFR) training is also known as blood flow restriction moderation which involves restricting venous and arterial blood flow to an exercising muscle to increase strength gains and support muscle hypertrophy.3 Additionally, (BFR) training involves the use of cuffs placed near around the proximal part of a limb, for maintaining blood vessel inflow while restricting venous return during the exercise.4 One of the important benefits of (BFR) resistance exercises is that relatively light loads can be used to facilitate hypertrophic responses similar to traditional high-load unrestricted resistance exercise. 5Although the use of (BFR) resistance exercise seems to be effective, the mechanisms underpinning the hypertrophic adaptations are yet to be fully determined such as resistance exercises, strength, endurance, and high-intensity hypoxia training. 6 Consistently with (BFR) resistance exercises also strength training is a necessary element to most sports programs, and there are varying irregularly schools of thought and training terms used to enhance muscular strength, and a large portion of them are recognized and effective. Why blood flow restriction?While the American College of Sports Medicine (ACSM) recommends training with a weight of at least 70% one repetition maximum (1RM) for achieving muscular strength and hypertrophy, as it is believed anything below this intensity scarcely produces radical muscle growth.8 (BFR) training can increase muscular strength, hypertrophy, and muscle endurance with 20-25% of (1RM) intensity, by decreasing the volume of training to 15-20 minutes per day and the volume of training per week from 1-3 sessions. Benefits of blood flow restrictionIn order to gain increases in the size and strength of skeletal muscle, it is commonly believed that training intensity of at least 65% of (1RM) is required.9 However, recent studies suggest such gains may be obtainable with considerably lower resistance in combination with (BFR), even in well-trained athletes with a history of resistance training.10 In addition, the proposed (BFR) benefits of muscle hypertrophy, 11−13 streng...
The authors describe the use of spironolactone, an aldosterone receptor blocker, in a patient with heart failure refractory to conventional therapy. The clinical importance of this case is that not only does spironolactone improve symptoms, but its use also improves survival in patients with severe heart failure. Clinicians should be aware that this therapy has to be added to the medical armamentarium for patients with severe heart failure. In addition, it is important to point out that the use of the aldosterone receptor blockers and their beneficial effects in morbidity and mortality in heart failure has helped to understand more clearly the relationship between aldosterone and its importance in the pathophysiology of heart failure. (c)2000 by CHF, Inc.
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