Comparison of the Effects of Carvedilol and Metoprolol on Exercise Ventilatory Efficiency in Patients With Congestive Heart Failure
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概要
- 論文の詳細を見る
Background The slope of the relationship between ventilation and carbon dioxide production (VE/VCO_2 slope), obtained during symptom-limited ramp exercise testing, reflects exercise ventilatory efficiency. Importantly, the VE/VCO_2 slope is related to prognosis in patients with congestive heart failure (CHF). The aim of the present study was to determine the relationship between the institution of β-blockers, carvedilol or metoprolol, and the VE/VCO_2 slope during exercise in patients with CHF. Methods and Results Fifty-seven patients with New York Heart Association functional class II or HI with a radionuclide left ventricular ejection fraction (LVEF) of less than 40% received carvedilol or metoprolol in a randomized fashion. The VE/VCO_2 slope, LVEF and plasma brain natriuretic peptide (BNP) concentration were determined before and after 16 weeks of treatment. LVEF improved (p<0.01), but the VE/VCO_2 slope and BNP did not. A significant improvement in the VE/VCCh slope was observed in patients with LVEF <29% or BNP >63pg/ml (respective baseline median values) (p<0.05, p<0.05). In patients with BNP >63pg/ml, the improvement effect on the VE/VCO_2 slope with carvedilol was significantly greater than that with metoprolol (p<0.05) and a significant improvement in the VE/VCO_2 slope was observed only in those who took carvedilol (p<0.01). Conclusions The VE/VCO_2 slope was not improved after β-blocker therapy in any of the patients. However, it did improve in patients with a lower LVEF or higher BNP level at baseline, and carvedilol was more effective than metoprolol in improving the VE/VCO_2 slope in patients with higher BNP levels at baseline.
- 社団法人日本循環器学会の論文
- 2008-02-20
著者
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Ogawa Satoshi
Cardiopulmonary Division, Department of Internal Medicine, Keio University School of Medicine
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Sato Toru
Department Of Medical Education Keio University School Of Medicine
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Yoshikawa Tsutomu
Cardio-pulmonary Division of Keio University School of Medicine
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Kataoka Masaharu
Division of Cardiology, Department of Internal Medicine, Keio University School of Medicine
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Kataoka Masaharu
Cardiology Division Department Of Medicine Keio University School Of Medicine
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Anzai Toshihisa
Cardio-pulmonary Division of Internal Medicine, Keio University School of Medicine
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Anzai Toshihisa
Division Of Cardiology Department Of Medicine Keio University School Of Medicine
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Yoshikawa Tsutomu
Cardiology Division Department Of Medicine Keio University School Of Medicine
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KOHNO Takashi
Cardiology Division, Department of Medicine, Keio University School of Medicine
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Yoshizawa Akihiro
Tokyo Dental College Ichikawa Hospital
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Nakamura Iwao
Hino Municipal Hospital
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Satoh Toru
Cardiology Division, Department of Internal Medicine, Keio University School of Medicine
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Kohno Takashi
Cardiology Division Department Of Medicine Keio University School Of Medicine
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Satoh Takahiro
Department Of Cardiology Tokyo Women's Medical University
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Nakamura Iwao
Department of Cardiology, Hino Municipal Hospital
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Yoshizawa Akihiro
Cardiopulmonary Division, Department of Medicine, Keio University School of Medicine
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Anzai Toshihisa
Cardiology Division Department Of Medicine Keio University School Of Medicine
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Yoshikawa Tsutomu
University Of Tokyo
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Yoshikawa Tsutomu
Cardiopulmonary Division Department Of Medicine School Of Medicine Keio University
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Kataoka Masaharu
Division Of Cardiology Department Of Medicine Keio University School Of Medicine
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Satoh Toru
Cardiopulmonary Division Department Of Internal Medicine Keio University School Of Medicine
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Sato Toshihiko
Department Of Cardiology Tokyo Women's Medical University
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Ogawa Satoshi
Cardio-pulmonary Division Department Of Medicine Keio University School Of Medicine
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Kawakami Takashi
Department Of Regenerative Medicine And Advanced Cardiac Therapeutics Keio University School Of Medi
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Kageyama Toshimi
Division Cardiology Department Of Internal Medicine Keio University School Of Medicine
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Satou Toshihiko
Cardiopulmonary Division Department Of Internal Medicine Keio University School Of Medicine
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Satou Tohru
Department Of Medicine School Of Medicine Keio University
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Satou Toshihiko
Cardiopulmonary Division Department Of Medicine Keio University School Of Medicine
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Nakamura Iwao
Department Of Emergency And Critical Care Medicine School Of Medicine Keio University
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Sakamoto Tomohiro
Cardiopulmonary Division Keio University
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Tahara Satoko
Department Of Cardiology Tokyo Women's Medical University
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Satoh Toshiaki
Department Of Regenerative Medicine And Advanced Cardiac Therapeutics Keio University School Of Medi
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Sato Toshiaki
Cardiopulmonary Division Keio University
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Kataoka Masaharu
Department Of Cardiology Keio University School Of Medicine
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Kataoka Masaharu
Department Of Regenerative Medicine And Tissue Engineering National Cardiovascular Center Research Institute
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Kataoka Masaharu
Division Of Cardiology Department Of Medicine Kyorin University School Of Medicine
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Kageyama Toshimi
Department Of Regenerative Medicine And Advanced Cardiac Therapeutics Keio University School Of Medicine
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