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Related Concept Videos

Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers01:27

Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers

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β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
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Antihypertensive Drugs: Types of β-Blockers01:28

Antihypertensive Drugs: Types of β-Blockers

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β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
768
Antihypertensive Drugs: Action of β1 Blockers01:17

Antihypertensive Drugs: Action of β1 Blockers

494
β1-receptors are primarily located in the heart and kidneys. In cardiac myocytes, these receptors interact with neurotransmitters released by the sympathetic nervous system during heightened activity or danger. As a result, β1-receptors get activated, initiating a series of biochemical processes. Excessive activation of beta receptors due to chronic stress can abnormally increase heart rate and contractility, resulting in high blood pressure or hypertension. To counteract this,...
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Adrenergic Antagonists: ɑ and β-Receptor Blockers01:31

Adrenergic Antagonists: ɑ and β-Receptor Blockers

527
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
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Cardiac Output I:Effect of Heart Rate on Cardiac Output01:19

Cardiac Output I:Effect of Heart Rate on Cardiac Output

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Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
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Surgical Placement of Catheters for Long-term Cardiovascular Exercise Testing in Swine
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In Cardiac Patients β-Blockers Attenuate the Decrease in Work Rate during Exercise at a Constant Submaximal Heart

Giovanni Baldassarre1, Valeria Azzini, Lucrezia Zuccarelli1

  • 1Department of Medicine, University of Udine, Udine, ITALY.

Medicine and Science in Sports and Exercise
|May 31, 2023
PubMed
Summary
This summary is machine-generated.

In cardiac patients, work rate decreased less at a fixed heart rate when taking beta-blockers. This suggests beta-adrenergic stimulation impacts exercise tolerance and aerobic exercise prescription.

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Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Exercise prescription using fixed heart rate (HR) values does not correlate with a specific work rate (WR) during prolonged exercise.
  • This phenomenon, potentially linked to HR kinetics and beta-adrenergic activity, has not been studied in cardiac patients.

Purpose of the Study:

  • To quantify the decrease in WR at a fixed HR in cardiac patients.
  • To determine if beta-blockers attenuate this WR decrease.

Main Methods:

  • Seventeen coronary artery disease patients were divided into beta-blocker (BB) and no-beta-blocker (no-BB) groups.
  • Patients underwent incremental exercise and a 15-min "HR CLAMPED" exercise, where WR was adjusted to maintain a constant HR (gas exchange threshold +15%).
  • HR was monitored via ECG, and pulmonary gas exchange was measured breath-by-breath.

Main Results:

  • The decrease in WR to maintain a constant HR was less pronounced in the BB group (-16% ± 10%) compared to the no-BB group (-27% ± 10%).
  • Oxygen consumption (V̇O2) decreased only in the no-BB group during the HR CLAMPED exercise.
  • Peak HR during incremental exercise was lower in the BB group.

Conclusions:

  • The reduced WR decrease at a fixed HR in cardiac patients on beta-blockers suggests a role for beta-adrenergic stimulation.
  • This phenomenon may indicate impaired exercise tolerance in cardiac patients and complicates aerobic exercise prescription.