Efficacy of beta-blocker therapy in symptomatic athletes with exercise-induced intra-ventricular gradients

Cardiovascular Ultrasound

Research

José P Andrade¹  Rita Miranda¹  Ana R Almeida¹  Luís R Lopes¹  Carlos Cotrim²  Manuel Carrageta³  Almeida G Ana⁴  Hortense Cotrim⁵  Eugenio Picano⁶ 

[1] Cardiology Department, Garcia de Orta Hospital, Almada, Portugal;Cardiology Department, Garcia de Orta Hospital, Almada, Portugal;Health School Egas Moniz, Instituto Superior de Saúde Egas Moniz, Caparica, Portugal;Lisboa University Medical School, Lisboa, Portugal;Cardiology Department, Garcia de Orta Hospital, Almada, Portugal;Lisboa University Medical School, Lisboa, Portugal;Cardiology Department, Santa Maria Hospital, Lisboa, Portugal;Lisboa University Medical School, Lisboa, Portugal;Health School Egas Moniz, Instituto Superior de Saúde Egas Moniz, Caparica, Portugal;Lisboa University Medical School, Lisboa, Portugal;Institute of Clinical Physiology of CNR, Pisa, Italy;

关键词: Beta Blocker;    Left Ventricular Mass Index;    Bisoprolol;    Left Ventricular Outflow Tract;    Relative Wall Thickness;   

DOI  :  10.1186/1476-7120-8-38

 received in 2010-08-11, accepted in 2010-09-02,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundUpright exercise stress echocardiography (SE) induces significant intraventricular gradient (IVG) and systolic anterior motion (SAM) in a large proportion of symptomatic athletes, who may therefore benefit from a negative inotropic therapy.The purpose of the present study was to assess the effect of chronic oral β blocker therapy on the occurrence of exercise-induced IVG and mitral valve SAM, in symptomatic athletes.MethodsWe enrolled 35 symptomatic athletes (age = 23 ± 11 years) with IVG (>30 mmHg) during SE off therapy. All repeated SE on chronic oral beta-blocker therapy (atenolol up to 50 mg, bisoprolol up to 10 mg, or metoprolol up to 100 mg daily according to physician-driven choice).ResultsOn therapy, there was during SE a reduction in IVG (35 off vs 17 on beta blocker, p < 0.01), decrease of IVG (102 ± 34 mmHg off vs 69 ± 24 mmHg on beta blocker, p < 0.01), peak heart rate (178 ± 15 bpm off vs 157 ± 9 bpm on beta blocker), SAM (24 off vs 9 on beta blocker, p < 0.001), symptoms during SE (17 off vs 2 on beta blocker p < 0.001), ST segment depression (13 off vs 2 on beta blocker, p < 0.001).ConclusionsIn athletes with positive screening on medical evaluation for sports practice and IVG on exertion, treatment with oral beta blockers improved symptoms in the large majority of patients. Symptomatic benefit was mirrored by objective evidence of improvement of echocardiographic signs of obstruction (IVG and SAM) and reduction of ischemia-like electrocardiographic changes.

【 授权许可】

CC BY   
© Cotrim et al; licensee BioMed Central Ltd. 2010