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Effects of cold exposure on submaximal exercise performance and adrenergic activation in patients with congestive heart failure and the effects of beta-adrenergic blockade (carvedilol or metoprolol).
Am J Cardiol. 2003 Sep 01; 92(5):548-53.AJ

Abstract

Patients with congestive heart failure (CHF) exhibit a decrease in maximal exercise capacity in response to a cold environment. The aim of this study was to further investigate the impact of cold exposure on submaximal exercise capacity, systemic adrenergic drive, and the effects of long-term beta-adrenergic blockade on these parameters. Thirty-three patients with CHF, with exercise limited by dyspnea and left ventricular ejection fraction of 26 +/- 4%, were randomized to receive metoprolol or carvedilol for 6 months. The observations were compared with 12 age-matched healthy volunteers. Maximal exercise performance with gas exchange analyses were assessed using a ramp protocol, and endurance capacity was measured using 2 constant-load exercise tests performed randomly at 20 degrees C and -8 degrees C. Healthy volunteers increased their submaximal exercise time by 20% (1,353 +/- 455 [20 degrees C] vs 1,635 +/- 475 seconds [-8 degrees C]; p <0.05), whereas patients with CHF exhibited a 21% decrease in exercise time (1,182 +/- 549 [20 degrees C] vs 931 +/- 524 seconds [-8 degrees C]; p <0.05) at -8 degrees C. Beta blockers increased submaximal exercise duration at 20 degrees C (+261 +/- 617 seconds; p <0.05) and -8 degrees C (+374 +/- 729 seconds; p <0.05). Norepinephrine increased to a greater extent at 4 minutes and at the time of exhaustion (at -8 degrees C) only in patients with CHF. Beta-adrenergic blockade caused no significant decrease in plasma norepinephrine levels. Patients with symptomatic CHF exhibited a significant decrease in submaximal exercise time in response to moderate cold exposure. Beta-blocker therapy with either metoprolol or carvedilol significantly increases submaximal exercise time and attenuates the impact of cold exposure on functional capacity.

Authors+Show Affiliations

Research Center, Montreal Heart Institute, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12943875

Citation

Blanchet, Martine, et al. "Effects of Cold Exposure On Submaximal Exercise Performance and Adrenergic Activation in Patients With Congestive Heart Failure and the Effects of Beta-adrenergic Blockade (carvedilol or Metoprolol)." The American Journal of Cardiology, vol. 92, no. 5, 2003, pp. 548-53.
Blanchet M, Ducharme A, Racine N, et al. Effects of cold exposure on submaximal exercise performance and adrenergic activation in patients with congestive heart failure and the effects of beta-adrenergic blockade (carvedilol or metoprolol). Am J Cardiol. 2003;92(5):548-53.
Blanchet, M., Ducharme, A., Racine, N., Rouleau, J. L., Tardif, J. C., Juneau, M., Marquis, J., Larivée, L., Nigam, A., Fortier, A., & White, M. (2003). Effects of cold exposure on submaximal exercise performance and adrenergic activation in patients with congestive heart failure and the effects of beta-adrenergic blockade (carvedilol or metoprolol). The American Journal of Cardiology, 92(5), 548-53.
Blanchet M, et al. Effects of Cold Exposure On Submaximal Exercise Performance and Adrenergic Activation in Patients With Congestive Heart Failure and the Effects of Beta-adrenergic Blockade (carvedilol or Metoprolol). Am J Cardiol. 2003 Sep 1;92(5):548-53. PubMed PMID: 12943875.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of cold exposure on submaximal exercise performance and adrenergic activation in patients with congestive heart failure and the effects of beta-adrenergic blockade (carvedilol or metoprolol). AU - Blanchet,Martine, AU - Ducharme,Anique, AU - Racine,Normand, AU - Rouleau,Jean Lucien, AU - Tardif,Jean Claude, AU - Juneau,Martin, AU - Marquis,Johanne, AU - Larivée,Lucie, AU - Nigam,Anil, AU - Fortier,Anick, AU - White,Michel, PY - 2003/8/29/pubmed PY - 2003/10/8/medline PY - 2003/8/29/entrez SP - 548 EP - 53 JF - The American journal of cardiology JO - Am J Cardiol VL - 92 IS - 5 N2 - Patients with congestive heart failure (CHF) exhibit a decrease in maximal exercise capacity in response to a cold environment. The aim of this study was to further investigate the impact of cold exposure on submaximal exercise capacity, systemic adrenergic drive, and the effects of long-term beta-adrenergic blockade on these parameters. Thirty-three patients with CHF, with exercise limited by dyspnea and left ventricular ejection fraction of 26 +/- 4%, were randomized to receive metoprolol or carvedilol for 6 months. The observations were compared with 12 age-matched healthy volunteers. Maximal exercise performance with gas exchange analyses were assessed using a ramp protocol, and endurance capacity was measured using 2 constant-load exercise tests performed randomly at 20 degrees C and -8 degrees C. Healthy volunteers increased their submaximal exercise time by 20% (1,353 +/- 455 [20 degrees C] vs 1,635 +/- 475 seconds [-8 degrees C]; p <0.05), whereas patients with CHF exhibited a 21% decrease in exercise time (1,182 +/- 549 [20 degrees C] vs 931 +/- 524 seconds [-8 degrees C]; p <0.05) at -8 degrees C. Beta blockers increased submaximal exercise duration at 20 degrees C (+261 +/- 617 seconds; p <0.05) and -8 degrees C (+374 +/- 729 seconds; p <0.05). Norepinephrine increased to a greater extent at 4 minutes and at the time of exhaustion (at -8 degrees C) only in patients with CHF. Beta-adrenergic blockade caused no significant decrease in plasma norepinephrine levels. Patients with symptomatic CHF exhibited a significant decrease in submaximal exercise time in response to moderate cold exposure. Beta-blocker therapy with either metoprolol or carvedilol significantly increases submaximal exercise time and attenuates the impact of cold exposure on functional capacity. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/12943875/Effects_of_cold_exposure_on_submaximal_exercise_performance_and_adrenergic_activation_in_patients_with_congestive_heart_failure_and_the_effects_of_beta_adrenergic_blockade__carvedilol_or_metoprolol__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002914903007239 DB - PRIME DP - Unbound Medicine ER -