Beneficial Effects of Heart Rate Reduction on Cardiac Mechanics and Energetics in Patients With Left Ventricular Dysfunction
スポンサーリンク
概要
- 論文の詳細を見る
It has been shown recently that the force-frequency relationship is blunted in experimental heart failure models. Furthermore, tachycardia is thought to have adverse effects on the diseased heart for several reasons, one of which is an increase in myocardial oxygen consumption. Inversely, the oxygen-saving effects of bradycardia may be beneficial for the treatment of heart failure. The aim of this study was to elucidate how heart rate(HR) modulates cardiac mechanics and energetics in patients with left ventricular(LV) dysfunction. LV pressure-volume data and myocardial oxygen consumption(MVO_2)was assessed using conductance and coronary sinus thermodilution catheters in 14 patients with moderate LV dysfunction(mean ejection fraction 34%)under 3 conditions: (a)basal, (b)HR increased by 20% using atrial pacing, and(c)HR decreased by 16% using a specific bradycardic agent, zatebradine(7.5 mg po). Atrial pacing decreased external work(EW)(from 0.39 to 0.31 J beat^<-1> m^<-2>, p<0.05)at a comparable MVO_2 per beat with a marginal increase in LV contractility index(E_<es>)(from 2.34 to 2.76 mmHg ml^<-1> m^<-2>, p=0.08), resulting in a decrease in mechanical efficiency(EW/MVO_2)(from 25.9 to 22.1%, p<0.05). In contrast, zatebradine did not decrease E_<es>(from 2.34 to 2.24 mmHg ml^<-1> m<-2>, NS), but increased EW(from 0.39 to 0.42 J beat^<-1> m<-2>, p<0.05 vs basal level)without a change in MVO_2 per beat, resulting in improved mechanical efficiency(from 25.9 to 29.7%, p<0.05 vs basal level). These results suggest that mild bradycardia is energetically advantageous and does not decrease myocardial contractility and performance, whereas pacing-induced tachycardia worsens cardiac mechanics and energetics in patients with LV dysfunction. Thus, the oxygen-saving effect of bradycardia may be beneficial for the treatment of heart failure.
- 社団法人日本循環器学会の論文
- 1999-11-20
著者
-
Yokoyama Mitsuhiro
Department Of Cardiology Kobe University Graduate School Of Medicine
-
Yokoyama Mitsuhiro
The First Department of Internal Medicine, Kobe University School of Medicine
-
Takeuchi Motoshi
The First Department of Internal Medcine,Kobe University School of Medicine
-
Shinke Toshirou
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
-
Shinke Toshiro
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
-
Shinke Toshiro
Kobe University Graduate School Of Medicine Division Of Cardiovascular Medicine Department Of Intern
-
TAKAOKA Hideyuki
The First Department of Internal Medicine Kobe University School of Medicine
-
Shinke Toshiro
The First Department of Internal Medicine Kobe University School of Medicine
-
Takeuchi Motoshi
The First Department Of Internal Medicine Kobe University School Of Medicine Kobe
-
Takeuchi Motoshi
The First Department Of Internal Medicine Kobe University School Of Medicine
-
Yokoyama Mitsuhiro
The First Department Of In Internal Medicine Kobe University School Of Medicine
-
Takaoka Hideyuki
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University
-
Teramukai Satoshi
Translational Research Center Kyoto University Hospital
-
Shinke Toshiro
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University
-
Takaoka Hideyuki
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University
-
Shinke Toshiro
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University
関連論文
- The Relation of 5'flanking Region of the Apolipoprotein(a) Gene to Serum Lipoprotein(a) Level
- IS021 Tranilast Inhibits Vascular Smooth Muscle Cell Growth and Intimal Hyperplasia by Induction of p21^
- -0149- NITRIC OXIDE SYNTHASE(NOS)ISOFORM ACTIVITIES IN KIDNEY OF DAHL SALT-SENSITIVE-RATS(PROCEEDINGS OF THE 59th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY)
- ASSOCIATION OF APOLIPOPROTEIN E PHENOTYPES WITH SERUM LIPOPROTEIN(a) LEVELS
- EFFECT OF HIGH SALT INTAKE ON THE PRODUCTION OF ENDOTHELIUM DERIVED NITRIC OXIDE
- Intraerythrocyte Sodium, Potassium and Magnesium in Human Adults
- Linking Phenomenon in Dual Atrioventricular Nodal Pathways
- Dynamic Effects of Intravenous Procainamide Infusion on the Electrophysiological Properties During Atrial Fibrillation
- Heart Rate Variability Before Spontaneous Episodes of Ventricular Tachycardia Originating From Right Ventricular Outflow Tract in Patients Without Organic Heart Disease
- P643 THE MECHANISM OF TERMINATION OF ATRIAL FIBRILLATION BY PROCAINAMIDE IN HUMAN
- Endothelial Lipase Gene Polymorphism is Associated With Acute Myocardial Infarction, Independently of High-Density Lipoprotein-Cholesterol Levels
- Dynamic Analysis of QT Dispersion and QT Interval for Identifying Patients with Organic Heart Disease at Risk for Ventricular Arrhythmias
- Comparative Usefulness of Beat-to-Beat QT Dispersion and QT Interval Fluctuations for Identifying Patients With Organic Heart Disease at Risk for Ventricular Arrhythmias
- Beneficial Effects of Exogenous Tetrahydrobiopterin on Left Ventricular Remodeling After Myocardial Infarction in Rats : The Possible Role of Oxidative Stress Caused by Uncoupled Endothelial Nitric Oxide Synthase
- IS102 Tumor Necrosis Factor-α Induces Protein Synthesis Through Phosphatidylinositol 3-Kinase-Akt/Protein Kinase B Pathway Activation in Cardiac Myocytes
- 1017 ANGIOTENSIN II STIMULATES MITOGEN-ACTIVATED PROTEIN KINASES AND PROTEIN SYNTHESIS BY A RAS-INDEPENDENT PATHWAY IN VASCULAR SMOOTH MUSCLE CELLS
- PE-095 Low Adiponectin Level is Associated with ACS Caused by Plaque Rupture Containing Lipid Necrotic Core(Acute coronary syndrome, basic/clinical-5, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- PE-076 Delayed Neointimalization on Sirolimus-eluting Stents Observed by Optical Coherence Tomography(Restenosis basic/clinical-2, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- The Blood Flow Response above Ventilatory Anaerobic Threshold in Patients with Well Preserved Cardiac Function
- Augmented Angiogenesis in Ischemic Limbs in Transgenic Mice Overexpressing eNOS in Endothelium
- ASSESSMENT OF THE FIRST DERIVATIVE OF THE MINNESOTA IMPEDANCE CARDIOGRAPH AS AN INDEX OF LEFT VENTRICULAR FUNCTION : IVth Auditorium : PROCEEDINGS OF THE 40TH ANNUAL MEETING OF THE JAPANESE CIRCULATION SOCIETY
- Endocardial Substrate Mapping for Monomorphic Ventricular Tachycardia Ablation in Ischemic and Non-Ischemic Cardiomyopathy
- Familial Adult Onset Primary Alveolar Hypoventilation Syndrome
- PE-234 Serum Beta2-microglobulin Levels Strongly Predict the Prognosis of Heart Failure in the Very Elderly Patients(Heart failure, clinical-07, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- Endomyocardial Abnormalities Associated with Symptomatic and/or Arrhythmogenic Mitral Valve Prolapse
- Plasma Tetrahydrobiopterin/Dihydrobiopterin Ratio : A Possible Marker of Endothelial Dysfunction
- P_2-PURINERGIC RECEPTOR MEDIATED PHOSPHOINOSITIDES (PI) METABOLISM IN CULTURED FETAL CARDIAC MYOCYTES : Myocardial Metabolism, Biochemistry : 53 Annual Scientific Meeting, Japanese Circulation Society
- REGULATION OF INDUCIBLE NITRIC OXIDE SYNTHASE _mRNA INDUCTION BY CYTOKINES IN CULTURED VASCULAR SMOOTH MUSCLE CELLS
- OE-163 Atherosclerotic Plaque Imaging using Phase-Contrast X-ray Computed Tomography : Seeking for Clinical Application(CT/DSA(01)(I),Oral Presentation(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- PE-320 Atherosclerotic Plaque Imaging by Interferometric Phase-Contrast X-ray Computed Tomography(CT/DSA-07, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- THE EFFECT OF RECENT ADVANCES IN PHARMACOLOGIC MANAGEMENT ON THE PROGNOSIS OF DILATED CARDIOMYOPATHY
- P507 STIMULATORY INTERACTION BETWEEN VASCULAR ENDOTHELIAL GROWTH FACTOR AND ENDOTHELIN-1 ON GENE EXPRESSION IN VASCULAR ENDOTHELIAL AND SMOOTH MUSCLE CELLS
- Endothelial Lipase is Increased by Inflammation and Promotes LDL Uptake in Macrophages
- P696 PRESERVED ENDOTHELIUM DEPENDENT VASODILATATION OF EPICARDIAL SPASTIC SITE AND RESISTANSE CORONARY ARTERIES IN PATIENTS WITH VASOSPASTIC ANGINA.
- 0346 ENDOTHELIUM DEPENDENT VASODILATATION IN PERIPHERAL CIRCULATION OF PATIENTS WITH VARIANT ANGINA IS NOT IMPAIRED
- Effect of Beta-Blocker Therapy on Severe Ventricular Arrhythmias in Patients With Idiopathic Dilated Cardiomyopathy
- Diabetes Mellitus and Cardiomyopathy : Association With Mutation in the Mitochondrial tRNA^gene
- P743 HISTOLOGIC FEATURE OF DILATED CARDIOMYOPATHY WITH VENTRICULAR ARRHYTHMIA WHICH IS NOT IMPROVED
- 0602 N-CADHERIN EXPRESSION IN HUMAN VENTRICULAR MYOCARDIUM OF CARDIOMYOPATHY
- P495 MOLECULAR ANALYSIS OF SEROTONIN (5-HYDROXY-TRYPTAMINE; 5-HT) RECEPTOR SUBTYPES IN HUMAN CORONARY ARTERIES
- 0959 HEPARAN SULFATE AND HEPARIN INHIBIT ENDOTHELIN-1- OR TPA-INDUCED MAP KINASE ACTIVATION AND c-fos GENE EXPRESSION IN MYOCARDIAL CELLS
- 0683 THE N-TERMINAL MYRISTOYLATION IS IMPORTANT FOR STRETCH-INDUCED ACTIVATION OF ENDOTHELIAL CELL NITRIC OXIDE SYNTHASE
- -1344- MOLECULAR ANALYSIS OF 5-HYDROXYTRIPTAMINE RECEPTORS IN HUMAN CORONARY ARTERIES(PROCEEDINGS OF THE 59th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY)
- 経過中血性心のう液貯留を認めた Stunned Myocardium の一例
- Feasibility of combined use of intravascular ultrasound radiofrequency data analysis and optical coherence tomography for detecting thin-cap fibroatheroma
- Relation Between Plasma Adiponectin, High-Sensitivity C-Reactive Protein, and Coronary Plaque Components in Patients With Acute Coronary Syndromecoherence tomography
- PE-347 Determinants of Plaque Progression in Patients with Stable Angina : Serial Intravascular Ultrasound Virtual Histology Study(Intravascular endoscopy/Intravascular ultrasound-4, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- 1 Catheter-based Transcoronary Myocardial Hypothermia Attenuates Reperfusion Injury in Pigs with Acute Myocardial Infarction(Discovery of Adjunctive Therapies for Acute Myocardial Infarction-From Bench to Bedside-, The 71st Annual Scientific Meeting of th
- IS069 ALTERED MYOCARDIAL ENERGETICS IN PATIENTS WITH REMODELED HEART AFTER MYOCARDIAL INFARCTION
- Close Correlation of Endothelial Function between Coronary and Brachial Circulation in Patients with Idiopathic Dilated Cardiomyopathy
- Antioxidant Agent, Glutathione Improves Contractile Response to Dobutamine and Mechanical Efficiency in Patients with Reduced Left Ventricular Function
- OJ-070 Detection of the Defibrillation Threshold Using the Upper Limit of Vulnerability Testing During Defibrillator Implantation(Arrhythmia, therapy-06, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- OE-149 Electrophysiological Characteristics of Posteromedial Right Atrium (Sinus Venosa Region) and Atrial Fibrillation Occurrence after Inferior Vena Cava-Tricuspid Annulus Isthmus Ablation(Arrhythmia, diagnosis/pathophysiology/EPS-02, The 71st Annual Sc
- PJ-159 The Early Effects of Carvediol Therapy on Beat-to-beat QT dispersion in Patients with Congestive Heart Failure(ECG/Body surface potential mapping/Holter-6 () PJ27,Poster Session (Japanese),The 70th Anniversary Annual Scientific Meeting of the Japan
- PE-544 Efficacy of Burst Pacing Set in 91% of Cycle-length, 13 Pulses for Ventricular Tachycardia in Patents with Implantable Cardioverter-Defibrillator(Arrhythmia, therapy-13 (A) PE92,Poster Session (English),The 70th Anniversary Annual Scientific Meetin
- PE-155 Endocardial Substrate Mapping and Ablation for Monomorphic Ventricular Tachycardia in Patients with Ischemic and Nonischemic Cardiomyopathy(Arrhythmia, therapy-11 (A) PE26,Poster Session (English),The 70th Anniversary Annual Scientific Meeting of t
- Risk Stratification for Cardiac Events in Patients with Organic Heart Disease and Low Ejection Fraction Using Beat-to-Beat QT Dispersion (ECG/Body Surface Potential Mapping/Holter 7 (A), The 69th Annual Scientific Meeting of the Japanese Circulation Socie
- Examination of Optimal Right Ventricular Pacing Site for Cardiac Resynchronization Therapy Guided by Electroanatomical Mapping(Heart Failure, Clinical 9 (M), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- Radiofrequency Catheter Ablation for Drug Refractory Electrical Storm in Implantable Cadioverter Defibrillator Recipients(Arrhythmia, Non-pharmacological Therapy 7 (A), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- PJ-400 The Predictive Value of Beat-to-Beat QT Dispersion for Stratifying Arrhythmic Risk in Ischemic Heart Disease(ECG/Body Surface Potential Mapping/Holler 5 (A) : PJ67)(Poster Session (Japanese))
- PJ-399 The Usefullness of Beat-to-Beat QT Dispersion for Identifying Patients with Nonischemic Dialated Cardiomyopaty at Risk for Ventricular Arrhythmias(ECG/Body Surface Potential Mapping/Holler 5 (A) : PJ67)(Poster Session (Japanese))
- OE-221 Radiofrequency Catheter Ablation Guided by Electro-Anatomical Maps (CARTO System) for Un-mappable Ventricular Tachycardia(Arrhythmia, Non-Pharmacological Therapy 9 (A) : OE27)(Oral Presentation (English))
- Role of Angiotensin and the Clock System in the Circadian Regulation of Plasminogen Activator Inhibitor-1
- FRS-112 Pressure-overload Induced Hypertrophied Hearts Displayed Regional Differences in Cross-bridge Dynamics : Evidence from X-Ray Diffraction Study Using Synchrotron Radiation(New Concepts for Assessing Cardiac Function(M),Featured Research Session,The
- Inhibition of Endogenous Nitric Oxide Synthase Augments Contractile Response to Adenylyl Cyclase Stimulation Without Altering Mechanical Efficiency in Patients With Idiopathic Dilated Cardiomyopathy
- Relationship Between Coronary Plaque Formation and NAD(P)H Oxidase-derived Reactive Oxygen Species : Comparison of Intravascular Ultrasound Finding of Atherosclerotic Lesions with Histochemical Characteristics
- PJ-450 Usefulness of Assessing Myocardial Washout of ^Tc-tetrofosmin for Prediction of Prognosis in Patients with Cardiac Sarcoidosis(Cardiomyopathy, basic/clinical-7, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- PE-457 Endothelial Lipase is Increased by Inflammation and Promotes LDL Uptake in Macrophages(Infection/Inflammation/Immunity-2, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- PE-209 VEGF Upregulation In Mice Lacking Endothelin-1 In Vascular Endothelial Cell Compensates the Lack of Heart Vascularization on the Expense of Inflammation(Cardiac hypertrophy, basic/clinical-2, The 71st Annual Scientific Meeting of the Japanese Circu
- PE-079 ACE Inhibitors (ACE-I) and Angiotensin Receptor Blockers (ARB) Have Different Effects on the Circadian Expression of Plasminogen Activator Inhibitor-1 (PAI-1)(Thromboembolism/Antithrombotic therapy/Thrombolysis-2, The 71st Annual Scientific Meeting
- THE SIGNIFICANCE OF STENOTIC LESION IN AN UNOCCLUDED CORONARY ARTERY : A Manifestation of Myocardial "Ischemia at a Distance" during Acute Coronary Occlusion
- THE MODULATION OF CORONARY COLLATERAL VESSEL TONUS BY VASOACTIVE SUBSTANCES : Coronary Circulation : 46th Annual Scientific Meeting, Japanese Circulation Society
- EFFECTS OF ERGONOVINE-INDUCED VASOCONSTRICTION ON THE GENESIS OF MYOCARDIAL ISCHEMIA DURING CORONARY STENOSIS IN DOGS : Coronary Circulation : 46th Annual Scientific Meeting, Japanese Circulation Society
- -P293- NITRIC OXIDE INHIBITS POLYMORPHONUCLEAR LEUKOCYTES ADHESION TO CYTOKINE-ACTIVATED CARDIAC MYOCYTES(PROCEEDINGS OF THE 59th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY)
- Expressions of Endothelial Constitutive Nitric Oxide Synthase mRNA and Protein in Atherosclerotic vessels : Analysis by In Situ Hybridization and Immunocytochemistry
- Comparison of Endothelium-dependent vasodilating capacities of conduit and resistance arteries between coronary and brachial circulation
- Vitamin C enhances the contractile response to dobutamine and mechanical efficiency in patients with previous myocardial infarction
- Beneficial Effects of Heart Rate Reduction on Cardiac Mechanics and Energetics in Patients With Left Ventricular Dysfunction
- 0243 BENEFICIAL EFFECT OF SPECIFIC BRADYCARDIAC AGENT ON CARDIAC ENERGETICS FOR THE TREATMENT OF HEART FAILURE : IN COMPARISON WITH BETA-BLOCKER
- 0061 BENEFICIAL EFFECT OF BRADYCARDIA ON LEFT VENTRICULAR MECHANICS AND ENERGETICS IN PATIENTS WITH HEART FAILURE.
- P147 Disociation Between Responces of Systolic and Diastolic Properties to Tachycardia in Severe Heart Failure.
- 0370 Preservation of Myocardial Energy Cost can Explain Excellent Tolerance in the Initiation of β-Blockade Therapy.
- 0034 Effects of Tachycardia on Left Ventricular(LV)Contractulity and Myocardial Energy Cost in Patients With Heart Failure.
- Measurement of Left Ventricular Volume by Dual-Field Conductance Catheter in Humans : Comparison With Single-Field Conductance Catheter
- -P612- Comparison of the Effect on Myocardial Energetics between β-Stimulation, Phospho-Diesterase Inhibition and Ca^ Sensitization(PROCEEDINGS OF THE 59th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY)
- -0102- Beneficial Effects of a Ca^ Sensitizer, MCI-154, on Myocardial Oxygen Consumption-Cardiac Output Relation : In Comparison with Dobutamine and Phosphodiesterase Inhibitor(PROCEEDINGS OF THE 59th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULAT
- -0101- REDUCTION IN OXYGEN EXPENDITURE FOR NON-MECHANICAL WORK IN THE INITIATION OF BETA-BLOCKADE THERAPY. A ROLE OF NEGATIVE CHRONOTROPIC EFFECT.(PROCEEDINGS OF THE 59th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY)
- Assessment of Left Ventricular Function Using a Conductance Catheter in the Human Heart : CLINICAL EVALUATION OF CARDIAC PERFORMANCE
- FRS-104 Plasma Biopterin Levels as a Biomarker of Endothelial Dysfunction(Biomarker of Cardiovascular Disease, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- Adenoviral Transfer of Rho Family Proteins to Lung Cancer Cells Ameliorates Cell Proliferation and Motility and Increases Apoptotic Change
- Serum beta2-microglobulin concentration as a novel marker to distinguish levels of risk in acute heart failure patients
- Determinants of Heart Rate Recovery in Patients with Suspected Coronary Artery Disease
- FRS-042 Targeted Inactivation of Endothelial Cell-selective Adhesion Molecule Inhibits Susceptibility to Atherosclerosis in Apoprotein-E-deficient Mice(Vascular Biology in Endothelial Cells (basic), The 71st Annual Scientific Meeting of the Japanese Circu
- 3 Clinical Usefulness of Optical Coherence Tomography in Coronary Imaging(Advanced in Visual Assessment of Coronary Atherosclerotic Disease, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- PJ-241 A Sandwich Enzyme-linked Immunosorbent Assay for Human Endothelial Lipase Concentration(Lipid disorders-3 (H) PJ41,Poster Session (Japanese),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Society)
- OE-076 Endothelial Lipase-Deficient Mice are Protected Against Lipopolysaccharide-Induced Cardiac Inflammation and Left Ventricular Dysfunction(Infection/Inflammation/Immunity-1 (H) OE13,Oral Presentation (English),The 70th Anniversary Annual Scientific M
- 5 Novel Aspects of a Classical Marker for Cardiovascular Disease : Link between Oxidative Stress and Inflammation by Vascular C-Reactive Protein(Plenary Session 2 (PL2) (IHD) : Inflammation and Atherosclerosis : From Bench to Bedside)(Special Program)
- Long-Term Follow Up of DDD-Right Ventricular Apex Pacing for Sick Sinus Syndrome and Atrioventricular Block
- Incidence, Clinical Characteristics and Prognosis of Left Bundle Branch Block Induced Cardiomyopathy in Patients with Idiopathic Dilated Cardiomyopathy after Cardiac Resynchronization Therapy
- Predictive importance of left ventricular myocardial stiffness for the prognosis of patients with congestive heart failure