Acetylcholinesterase inhibition with pyridostigmine improves heart rate recovery after maximal exercise in patients with chronic heart failure
Acetylcholinesterase inhibition with pyridostigmine improves heart rate recovery after maximal exercise in patients with chronic heart failure
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DOI：
10.1136/heart.89.8.854
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发表时间：
2003-08-01
期刊：
影响因子：
5.7
通讯作者：
Katz, SD
中科院分区：
文献类型：
--
作者：
Androne, AS;Hryniewicz, K;Katz, SD
目的：目的：探讨吡啶斯的明抑制乙酰胆碱酯酶对慢性心力衰竭（CHF）患者副交感神经张力的影响。设计：前瞻性、随机、双盲、交叉试验。地点：大学医院门诊心力衰竭门诊。患者：20例稳定性CHF患者（平均年龄55岁，平均射血分数24%）。干预措施：口服单剂量吡啶斯的明30毫克和匹配的安慰剂在不同的日子。主要结果测量：结果：服用吡斯的明后运动后1分钟的心率恢复显著高于服用安慰剂后（平均（SEM）27.4（3.2）次/分v22.4（2.4）次/分，p < 0.01）。运动后3分钟的心率恢复在吡啶斯的明和安慰剂给药后没有差异（平均（SEM）44.4（3.9）次/分vs 41.8（3.6）次/分，NS）。峰值心率，峰值摄氧量，峰值呼吸交换率，血浆去甲肾上腺素（去甲肾上腺素）浓度，血浆脑钠肽浓度并没有显着差异后，管理的pyridostigmine和安慰剂Conclusions：乙酰胆碱酯酶抑制与pyridostigmine增加心率恢复在一分钟，但不是在运动后三分钟。吡啶斯的明对运动后1分钟心率的特异性作用表明，吡啶斯的明增强CHF患者的副交感神经张力。
Objective: To characterise the effects of acetylcholinesterase inhibition with pyridostigmine on parasympathetic tone in patients with chronic heart failure (CHF).Design: Prospective randomised, double blind crossover trial.Setting: University hospital outpatient heart failure clinic.Patients: 20 ambulatory subjects with stable CHF (mean age 55 years, mean ejection fraction 24%).Interventions: Oral administration of a single dose of pyridostigmine 30 mg and matching placebo on separate days.Main outcome measures: Heart rate recovery at one minute and three minutes after completion of maximal exercise.Results: Heart rate recovery at one minute after exercise was significantly greater after administration of pyridostigmine than after administration of placebo (mean (SEM) 27.4 (3.2) beats/min v 22.4 (2.4) beats/min, p < 0.01). Heart rate recovery at three minutes after exercise did not differ after administration of pyridostigmine and placebo (mean (SEM) 44.4 (3.9) beats/min v 41.8 (3.6) beats/min, NS). Peak heart rate, peak oxygen uptake, peak respiratory exchange ratio, plasma noradrenaline (norepinephrine) concentrations, and plasma brain natriuretic peptide concentrations did not differ after administration of pyridostigmine and placebo.Conclusions: Acetylcholinesterase inhibition with pyridostigmine increased heart rate recovery at one minute but not at three minutes after exercise. A specific effect of pyridostigmine on heart rate one minute after exercise suggests that pyridostigmine augments parasympathetic tone in patients with CHF.