Avtor/Urednik		Podbregar, Matej
Naslov		Spremembe presnove v mirovanju pri zdravljenju kroničnega srčnega popuščanja z zaviralci adrenergičnih receptorjev beta
Prevedeni naslov		Effects of beta blockers on resting energy production rate and total body substrate oxidation rate in chronic heart failure
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Medicinska fakulteta
Leto izdaje		2003
Obseg		str. 46
Jezik		slo
Abstrakt		BACKGROUND. In chronic heart failure (CHF) beta-blockers reduce myocardial oxygen consumption and improve myocardial efficiency by shifting myocardial substrate utilization from increased free fatty acid oxidation to increased glucose oxidation. The effect of selective and non-selective beta-blockers on total body resting energy production rate (EPR) and substrate utilization is not known. METHODS. Twenty-six non-cachectic patients with moderately severe heart failure (NYHA class II or III, left ventricular ejection fraction < 0.40) were included. They we treated for 6 months: 13 patients with carvedilol (37.5±13.5 mg/12h) and 13 patients with bisoprolol (5.4±3.0 mg/d). Indirect calorimetry for measuring EPR and substrate utilization was performed before and after 6 months of treatment. RESULTS. Resting EPR was decreased in carvedilol (5.021±0.803 to 4.552±0.615 kJ/min, p<0.001) and bisoprolol group (5.230±0.828 to 4.978±0.640 kJ/min, p<0.05; non significant difference between groups). Lipid oxidation rate decreased in carvedilol and remained unchanged in bisoprolol group (2.4±1.4 to 1.5±0.9 mg m2/kg min vs. 2.7±1.1 to 2.5±1.1 mg m2/kg min, p<0.05). Glucose oxidation rate was increased only in carvedilol (2.6±1.4 to 4.4±1.6 mg m2/kg min, p<0.05), but did not change in bisoprolol group. Heart rate was correlated with EPR (r=0.53, p<0.001) CONCLUSIONS. Both selective and non-selective beta-blockers reduce total body resting EPR in non-cachectic CHF patients. Carvedilol compared to bisoprolol shifts total body substrate utilization from lipid to glucose oxidation. Monitoring heart rate can be useful for estimation of resting EPR in CHF patients.
Deskriptorji		HEART FAILURE, CONGESTIVE ADRENERGIC BETA-ANTAGONISTS ENERGY METABOLISM STROKE VOLUME BISOPROLOL CALORIMETRY, INDIRECT HEART RATE BLOOD PRESSURE GLUCOSE PALMITATES AMINO ACIDS BODY MASS INDEX NOREPINEPHRINE EPINEPHRINE FATTY ACIDS, NONESTERIFIED URIC ACID ANALYSIS OF VARIANCE