Effects of ??-Blocker Versus ?1-Blocker Treatment on Heart Rate Response During Incremental Cardiopulmonary Exercise in Japanese Male Patients with Subacute Myocardial Infarction

Shinji Nemoto, Yusuke Kasahara, Kazuhiro P. Izawa, Satoshi Watanabe, Kazuya Yoshizawa, Naoya Takeichi, Kentaro Kamiya, Norio Suzuki, Kazuto Omiya, Atsuhiko Matsunaga and Yoshihiro J. Akashi
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Shinji Nemoto: Department of Rehabilitation Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama 241-0811 Japan
Yusuke Kasahara: Department of Rehabilitation Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama 241-0811 Japan
Kazuhiro P. Izawa: Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan
Satoshi Watanabe: Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital, Kawasaki 216-8511, Japan
Kazuya Yoshizawa: Department of Rehabilitation Medicine, Kawasaki Municipal Tama Hospital, Kawasaki 214-8525, Japan
Naoya Takeichi: Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital, Kawasaki 216-8511, Japan
Kentaro Kamiya: Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara 252-0373, Japan
Norio Suzuki: Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama 241-0811, Japan
Kazuto Omiya: Department of Internal Medicine, Shimazu Medical Clinic, Yokohama 226-0026, Japan
Atsuhiko Matsunaga: Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara 252-0373, Japan
Yoshihiro J. Akashi: Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Hospital, Kawasaki 216-8511, Japan

IJERPH, 2019, vol. 16, issue 16, 1-12

Abstract: A simplified substitute for heart rate (HR) at the anaerobic threshold (AT), i.e., resting HR plus 30 beats per minute or a percentage of predicted maximum HR, is used as a way to determine exercise intensity without cardiopulmonary exercise testing (CPX) data. However, difficulties arise when using this method in subacute myocardial infarction (MI) patients undergoing beta-blocker therapy. This study compared the effects of αβ-blocker and β1-blocker treatment to clarify how different beta blockers affect HR response during incremental exercise. MI patients were divided into αβ-blocker ( n = 67), β1-blocker ( n = 17), and no-β-blocker ( n = 47) groups. All patients underwent CPX one month after MI onset. The metabolic chronotropic relationship (MCR) was calculated as an indicator of HR response from the ratio of estimated HR to measured HR at AT (MCR-AT) and peak exercise (MCR-peak). MCR-AT and MCR-peak were significantly higher in the αβ-blocker group than in the β1-blocker group ( p < 0.001, respectively). Multiple regression analysis revealed that β1-blocker but not αβ-blocker treatment significantly predicted lower MCR-AT and MCR-peak (β = −0.432, p < 0.001; β = −0.473, p < 0.001, respectively). Based on these results, when using the simplified method, exercise intensity should be prescribed according to the type of beta blocker used.

Keywords: myocardial infarction; beta-blocker; metabolic chronotropic relationship; chronotropic index; heart rate response; cardiac rehabilitation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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