Calcium channel blockers improve exercise capacity and reduce N-terminal Pro-B-type natriuretic peptide levels compared with beta-blockers in patients with permanent atrial fibrillation

Ulimoen, Sara R.; Enger, Steve; Pripp, Are Hugo; Abdelnoor, Michael; Arnesen, Harald; Gjesdal, Knut; Tveit, Arnljot

doi:10.1093/eurheartj/eht429

Cited by 69 publications

(50 citation statements)

References 45 publications

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“…Ze względu na ujemne działanie inotropowe należy ich unikać u pacjentów z HFrEF [222,534,535]. Werapamil i diltiazem mogą zmniejszać objawy związane z arytmią [526] w porównaniu z beta-adrenolitykami, które w jednej małej próbie klinicznej u pacjentów z grupy małego ryzyka z zachowaną LVEF ograniczały wydolność fizyczną i zwiększały stężenie peptydu natriuretycznego typu B [542].…”

Section: Antagoniści Wapnia Niebędący Pochodnymi Dihydropirydynyunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,383

4,206

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Section: Antagoniści Wapnia Niebędący Pochodnymi Dihydropirydynyunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,383

4,206

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“…Reduced exercise tolerance is, together with chest pain, palpitations and shortness of breath, one of the major symptoms of AF. The decline in exercise capacity during AF is typically on the order of 15% to 20% [6,7]. Drop in exercise performance during lone AF was found regardless of adequate ventricular rate control [8,9].…”

mentioning

confidence: 99%

A Computational Study on the Relation between Resting Heart Rate and Atrial Fibrillation Hemodynamics under Exercise

et al. 2017

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AimsClinical data indicating a heart rate (HR) target during rate control therapy for permanent atrial fibrillation (AF) and assessing its eventual relationship with reduced exercise tolerance are lacking. The present study aims at investigating the impact of resting HR on the hemodynamic response to exercise in permanent AF patients by means of a computational cardiovascular model.MethodsThe AF lumped-parameter model was run to simulate resting (1 Metabolic Equivalent of Task—MET) and various exercise conditions (4 METs: brisk walking; 6 METs: skiing; 8 METs: running), considering different resting HR (70 bpm for the slower resting HR—SHR—simulations, and 100 bpm for the higher resting HR—HHR—simulations). To compare relative variations of cardiovascular variables upon exertion, the variation comparative index (VCI)—the absolute variation between the exercise and the resting values in SHR simulations referred to the absolute variation in HHR simulations—was calculated at each exercise grade (VCI4, VCI6 and VCI8).ResultsPulmonary venous pressure underwent a greater increase in HHR compared to SHR simulations (VCI4 = 0.71, VCI6 = 0.73 and VCI8 = 0.77), while for systemic arterial pressure the opposite is true (VCI4 = 1.15, VCI6 = 1.36, VCI8 = 1.56).ConclusionsThe computational findings suggest that a slower, with respect to a higher resting HR, might be preferable in permanent AF patients, since during exercise pulmonary venous pressure undergoes a slighter increase and systemic blood pressure reveals a more appropriate increase.

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“…Верапамил и дилтиазем эффективно понижают ЧЖС и уменьшают симптомы у больных с постоянной ФП [21], но не показаны при систолической ХСН из-за отрицательного инотропного действия [22]. Напро-тив, понижение ЧЖС у пациентов с ХСН и сохранен-ной фракцией выброса левого желудочка с помощью верапамила или дилтиазема может сопровождаться улучшением толерантности к физической нагрузке и симптомов в сравнении с приемом бета-адренобло-каторов [23]. В отсутствии проспективных рандоми-зированных сравнительных исследований дигоксина у больных с ФП определенное беспокойство вызы-вали ретроспективно полученные данные о повыше-нии смертности при приеме дигоксина [24,25].…”

Section: современная фармакотерапия фибрилляции предсердийunclassified

State of the Art Pharmacological Therapy for Atrial Fibrillation

Канорский¹,

Коваленко²

2017

Russ J Cardiol

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Calcium channel blockers improve exercise capacity and reduce N-terminal Pro-B-type natriuretic peptide levels compared with beta-blockers in patients with permanent atrial fibrillation

Abstract: Rate-reducing treatment with diltiazem or verapamil preserved exercise capacity and reduced levels of NT-proBNP compared with baseline, whereas treatment with metoprolol or carvedilol reduced the exercise capacity and increased levels of NT-proBNP.

Cited by 69 publications

References 45 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

A Computational Study on the Relation between Resting Heart Rate and Atrial Fibrillation Hemodynamics under Exercise

State of the Art Pharmacological Therapy for Atrial Fibrillation

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