β-受体阻断剂对门肺高压患者运动能力及血流动力学的不良影响  

Deleterious effects of β-blockers on exercise capacity and hemodynamics in patients with portopulmonary hypertension

作　　者：Provencher S. Herve P. Jais X. 成虹(译) 陈云茹(校) 

机构地区：[1]Hopital Antoine Beclere, 157 rue de la Porte de Trivaux, 92140 Clamart, France [2]不详

出　　处：《世界核心医学期刊文摘（胃肠病学分册）》2006年第6期35-36,共2页Core Journals in Gastroenterology

摘　　要：Background &Aims: It has been suggested that β-blockers might be harmful in pulmonary arterial hypertension. However, no study has evaluated the effect of β-blockers in these patients. The aim of this study was to investigate the effect of β-blockers on exercise capacity and pulmonary hemodynamics in patients with portopulmonary hypertension receiving β-blockers for the prophylaxis of variceal bleeding. Methods: Ten consecutive patients with moderate to severe portopulmonary hypertension (mean pulmonary artery pressure of 52 [10]mmHg) underwent a 6 minute walk test and a right heart catheterization at baseline and 2 (1) months after β-blocker withdrawal. Results: Following β-blocker withdrawal, 9 of 10 patients increased their 6 minute walked distance with a mean increase in the whole group of 79 (78) meters (P = .01). Cardiac output increased by 28%(P < .01) with no change in mean pulmonary artery pressure, resulting in a 19%decrease in pulmonary vascular resistance (P < .01). Increases in cardiac output were related to a 25%increase in heart rate (P < .01), whereas stroke volume was unchanged (P = .65). The improvements in exercise tolerance were associated with increases in chronotropic response (maximal heart rate minus resting heart rate) from 18 (9) to 34 (12) beats/min (P < .01) during the 6-minute walk test. Conclusions: In patients with moderate to severe portopulmonary hypertension, β-blockers are associated with significant worsening in exercise capacity and pulmonary hemodynamics. These deleterious effects support the contraindication of β-blockers in patients with portopulmonary hypertension.Background ＆ Aims： It has been suggested that β-blockers might be harmful in pulmonary arterial hypertension. However, no study has evaluated the effect of β-blockers in these patients. The aim of this study was to investigate the effect of β-blockers on exercise capacity and pulmonary hemodynamics in patients with portopulmonary hypertension receiving β-blockers for the prophylaxis of variceal bleeding. Methods： Ten consecutive patients with moderate to severe portopulmonary hypertension （mean pulmonary artery pressure of 52 [10] mmHg） underwent a 6 minute walk test and a right heart catheterization at baseline and 2 （1） months after β-blocker withdrawal. Results： Following β-blocker withdrawal, 9 of 10 patients increased their 6 minute walked distance with a mean increase in the whole group of 79 （78） meters （P = . 01）. Cardiac output increased by 28% （P 〈. 01） with no change in mean pulmonary artery pressure, resulting in a 19% decrease in pulmonary vascular resistance （P 〈 . 01）. Increases in cardiac output were related to a 25% increase in heart rate （P 〈 . 01）, whereas stroke volumewas unchanged （P =. 65）.

关 键 词：Β-受体阻断剂 肺血流动力学 运动能力 肺高压 患者 不良影响 平均肺动脉压 右心导管插入术 静脉曲张出血 

分 类 号：R972[医药卫生—药品] R563[医药卫生—药学]