digoxin and Hyperemia

Long-term beta-adrenergic blockade does not appear to be associated with drug-induced training in patients with congestive heart failure (CHF); whether exercise training can increase peak aerobic capacity in patients with CHF who are treated with beta-adrenergic blockers is currently unknown.. We studied 23 patients with CHF who were treated with carvedilol or propranolol in addition to ACE inhibitors, furosemide, and digoxin. Of the patients treated with carvedilol, 8 underwent exercise training and 8 remained sedentary. All 7 patients treated with propranolol underwent exercise training. Peak oxygen consumption (mL.kg-1.min-1) was serially measured in trained and sedentary patients. Peak reactive hyperemia (mL.min-1.100 mL-1) was determined in the calf and forearm immediately before and after 12 weeks of training. The peak oxygen consumption of trained patients treated with either carvedilol or propranolol increased from 12.9 +/- 1.4 to 16.0 +/- 1.6 (P < .001) and 12.4 +/- 1.0 to 15.7 +/- 0.9 (P < .001) mL.kg-1.min-1, respectively, whereas it did not change in the sedentary patients. Peak reactive hyperemia increased significantly in the calves but not the forearms of trained patients.. Long-term, nonselective beta-adrenergic blockade with carvedilol or propranolol does not prevent patients with CHF from deriving systemic and regional benefits from physical training.

Topics: Adaptation, Physiological; Adrenergic beta-Antagonists; Aerobiosis; Aged; Angiotensin-Converting Enzyme Inhibitors; Carbazoles; Cardiotonic Agents; Carvedilol; Digoxin; Diuretics; Drug Therapy, Combination; Exercise Therapy; Female; Forearm; Furosemide; Heart; Heart Failure; Humans; Hyperemia; Leg; Male; Middle Aged; Oxygen Consumption; Propanolamines; Propranolol; Receptors, Adrenergic, beta

Topics: Aged; Asthma; Bronchitis; Carbon Dioxide; Cardiac Catheterization; Conjunctiva; Diet, Sodium-Restricted; Digoxin; Edema; Eye Diseases; Female; Furosemide; Heart Failure; Humans; Hyperemia; Male; Middle Aged; Oxygen; Oxygen Inhalation Therapy; Potassium Chloride; Pulmonary Emphysema; Pulmonary Fibrosis; Pulmonary Heart Disease; Respiratory Insufficiency; Veins