cardiovascular-agents and Lung-Diseases--Obstructive

To define the safety, informative value, and performance conditions of exercise echocardiography (EchoCG) in patients with stable angina (SA) concurrent with chronic obstructive pulmonary disease (COPD).. Forty patients aged 45 to 66 years (mean age 54.8 +/- 4.9 years) with Functional Class (FC) II-III SA concurrent with COPD and 40 patients aged 46 to 65 years (mean 56.6 +/- 4.9 years) with FC II-III SA without COPD were examined. All the patients underwent exercise EchoCG during the chosen therapy.. Exercise EchoCG is safe in patients with SA with COPD. To enhance the informative value of this test and to achieve the ischemic threshold in patients of this category require the use of adequate bronchodilator therapy. In this case, the informative value of the technique is 75%.. Exercise EchoCG in patients with SA concurrent with COPD may serve as a reliable tool in determining exercise endurance during antianginal, bronchodilator therapy and in assessing its adequacy.

Topics: Aged; Angina Pectoris; Bronchodilator Agents; Cardiovascular Agents; Echocardiography, Stress; Electrocardiography, Ambulatory; Exercise Test; Female; Heart Rate; Humans; Lung Diseases, Obstructive; Male; Middle Aged; Predictive Value of Tests; Sensitivity and Specificity

Beta-Blockers are often withheld from patients with obstructive airways disease, especially those with reversible airways disease due to fear of inducing bronchospasm. We report our single center experience of cautiously treating such patients who have concomitant chronic heart failure (CHF).. The use of cardioselective beta-blockers under caution and specialist supervision may be tolerable in many CHF patients with obstructive airways disease, resulting in clinical improvement rather than detriment.. A retrospective case notes analysis was performed on CHF outpatients who had obstructive airways disease and been treated with beta-blockers.. A total of 43 patients were identified, with an average ejection fraction of 31.8%; 18 of these patients had fixed obstructive airways disease, 15 patients had reversible obstructive airways disease, 10 patients had a label of obstructive airways disease (but no supporting evidence for the diagnosis in the hospital notes). In all 3 groups, beta-blockers had been initiated and maintained without any respiratory event over a median continuous exposure time of 135 days. Limitation of the dose was documented in only 2 patients because of worsening shortness of breath. New York Heart Association (NYHA) class significantly improved for the group with the use of these agents (p = 0.003).. A cautious approach (under specialist supervision) to beta-blocker use in patients with heart failure and airways disease can result in successful treatment. The implications of withholding these agents may have more serious consequences than their administration.

Topics: Adrenergic beta-Antagonists; Aged; Bronchial Spasm; Bronchoconstriction; Cardiovascular Agents; Chronic Disease; Heart Failure; Humans; Lung Diseases, Obstructive; Middle Aged; Patient Selection; Practice Guidelines as Topic; Retrospective Studies; Risk Assessment; Treatment Outcome

Topics: Adult; Aged; Blood Flow Velocity; Cardiovascular Agents; Carotid Arteries; Coronary Disease; Hemodynamics; Humans; Hypertension; Lung Diseases, Obstructive; Male; Middle Aged; Pacemaker, Artificial; Pulse

Topics: Adolescent; Adult; Aged; Cardiovascular Agents; Child; Female; Humans; Lung Diseases, Obstructive; Male; Medicine, Chinese Traditional; Medicine, East Asian Traditional; Microcirculation; Middle Aged