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Article

Effects of αβ-Blocker Versus β1-Blocker Treatment on Heart Rate Response During Incremental Cardiopulmonary Exercise in Japanese Male Patients with Subacute Myocardial Infarction

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Department of Rehabilitation Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama 241-0811 Japan
2
Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara 252-0373, Japan
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Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan
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Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital, Kawasaki 216-8511, Japan
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Department of Rehabilitation Medicine, Kawasaki Municipal Tama Hospital, Kawasaki 214-8525, Japan
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Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama 241-0811, Japan
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Department of Internal Medicine, Shimazu Medical Clinic, Yokohama 226-0026, Japan
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Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Hospital, Kawasaki 216-8511, Japan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(16), 2838; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16162838
Received: 24 June 2019 / Revised: 2 August 2019 / Accepted: 7 August 2019 / Published: 8 August 2019
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. View Full-Text
Keywords: myocardial infarction; beta-blocker; metabolic chronotropic relationship; chronotropic index; heart rate response; cardiac rehabilitation myocardial infarction; beta-blocker; metabolic chronotropic relationship; chronotropic index; heart rate response; cardiac rehabilitation
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MDPI and ACS Style

Nemoto, S.; Kasahara, Y.; Izawa, K.P.; Watanabe, S.; Yoshizawa, K.; Takeichi, N.; Kamiya, K.; Suzuki, N.; Omiya, K.; Matsunaga, A.; Akashi, Y.J. Effects of αβ-Blocker Versus β1-Blocker Treatment on Heart Rate Response During Incremental Cardiopulmonary Exercise in Japanese Male Patients with Subacute Myocardial Infarction. Int. J. Environ. Res. Public Health 2019, 16, 2838. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16162838

AMA Style

Nemoto S, Kasahara Y, Izawa KP, Watanabe S, Yoshizawa K, Takeichi N, Kamiya K, Suzuki N, Omiya K, Matsunaga A, Akashi YJ. Effects of αβ-Blocker Versus β1-Blocker Treatment on Heart Rate Response During Incremental Cardiopulmonary Exercise in Japanese Male Patients with Subacute Myocardial Infarction. International Journal of Environmental Research and Public Health. 2019; 16(16):2838. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16162838

Chicago/Turabian Style

Nemoto, Shinji, Yusuke Kasahara, Kazuhiro P. Izawa, Satoshi Watanabe, Kazuya Yoshizawa, Naoya Takeichi, Kentaro Kamiya, Norio Suzuki, Kazuto Omiya, Atsuhiko Matsunaga, and Yoshihiro J. Akashi 2019. "Effects of αβ-Blocker Versus β1-Blocker Treatment on Heart Rate Response During Incremental Cardiopulmonary Exercise in Japanese Male Patients with Subacute Myocardial Infarction" International Journal of Environmental Research and Public Health 16, no. 16: 2838. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16162838

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