Effects of Beta-Blocker on Cardiorespiratory Fitness Factors and Blood Lipid of Patients with Acute Coronary Syndrome

Chul Kim; Chul-Hyun Kim; Young-Joo Kim

doi:10.5763/kjsm.2011.29.2.105

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Kim, Kim, and Kim: Effects of Beta-Blocker on Cardiorespiratory Fitness Factors and Blood Lipid of Patients with Acute Coronary Syndrome

Clinical Article

Korean J Sports Med 2011;29(2):105-111.

Published online: 20 January 2011

DOI: https://doi.org/10.5763/kjsm.2011.29.2.105

Effects of Beta-Blocker on Cardiorespiratory Fitness Factors and Blood Lipid of Patients with Acute Coronary Syndrome

Chul Kim, MD, PhD¹, Chul-Hyun Kim, PhD², Young-Joo Kim, PhD¹

¹Department of Rehabilitation Medicine, Sanggye-Paik Hospital, Inje University College of Medicine, Seoul, Korea

²Sport Science Institute, Korea National Sport University, Seoul, Korea

Received 31 August 2011 Revised 14 November 2011 Accepted 29 November 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this study is to investigate effects of beta-blocker prescribed at the beginning of cardiac rehabilitation exercise for patients with acute coronary syndrome (ACS) on cardiorespiratory fitness factors and blood lipid at the 6th and the 14th week. The subjects of this study were patients (beta blocker group: n=20, non-beta blocker group: n=22) who underwent internal procedure because of ACS. The patients were conducted of exercise stress test and blood lipid before cardiac rehabilitation (the first period), were additionally prescribed of beta-blocker by cardiologist at the first week, and were conducted of exercise stress test and blood lipid at the 6th (the second period) and the 14th (the third period) week. Based on the results of this study, rest heart rate, maximal rate pressure product, sub-maximal rate pressure product, time and rate of perceived exertion showed no significant differences between groups, but _peak VO₂ showed interaction effect between treatment and period. All the items of blood lipid showed no differences between the groups. Conclusively, the group of beta-blocker administration showed negative effect on increase in _peak VO₂ at the 6th week but had positive effect at the 14th week. Meanwhile, beta-blocker did not affect blood lipid. Therefore, when patients with cardiovascular disease were additionally administered of beta-blocker at earlier period of cardiac rehabilitation, it may be needed of training time of at least six weeks to increase _peak VO₂.

Keywords: Beta-blocker, Cardiorespiratory fitness, Cardiac rehabilitation, Cardiovascular disease

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Table 1.

General characteristics of the 42 patients

	Beta blocker (n=20)	Non-beta blocker (n=22)	p-value
Age (y)	62.2±8.0	58.3±8.7	0.147
Height (cm)	162±9.4	160.5±9.2	0.585
UA (%)	50	59.1	0.554
AMI (%)	50	40.9	0.532
Weight (kg)	63.7±10.0	62.0±8.2	0.548
SBP (mm Hg)	125.2±26.2	118.3±16.2	0.299
DBP (mm Hg)	79.5±13.1	78.8±9.1	0.913
Medication
Aspirin	17 (85.0)	21 (95.5)	0.249
Clopidogrel	13 (65.0)	16 (72.7)	0.588
CCB	5 (25.0)	5 (22.7)	0.863
ARB	6 (30.0)	3 (13.6)	0.197
ACEI	7 (35.0)	9 (40.9)	0.694
Stain	17 (85.0)	18 (81.8)	0.782
Diuretics	2 (10.0)	4 (18.2)	0.449
Nitrate	11 (55.0)	8 (36.4)	0.226

Values are presented as mean±standard deviation or number (%). UA: unstable angina, AMI: acute myocardial infaction, SBP: systolic blood pressure, DBP: diastolic blood pressure, CCB: calcium channel blocker, ARB: angiotensin II recept-or blocker, ACEI: angiotensin converting enzyme inhibitor.

Table 2.

Change of hemodynamic response over time

		1 time	2 time	3 time	F-value	p-value
HR _rest (beat/min)	Beta blocker	75±12	65±11	67±11	1.371	0.260
	Non-beta blocker	80±13	76±8	73±9
MRPP	Beta blocker	23653±5842	22904±5441	21696±4297^†	3.513	0.05
	Non-beta blocker	25322±5283	25321±4986	27665±4437^§
RPP _sub	Beta blocker	16624±3461	12866±2862	12650±2643	0.023	0.977
	Non-beta blocker	17974±3809	14009±2796	13904±2806
Time	Beta blocker	787±135	905±69	888±137	0.876	0.42
	Non-beta blocker	786±149	937±104	929±100
peak VO₂ (mL/kg/min)	Beta blocker∗	26.6±6.0	28.1±5.0	28.9±4.4^‡	5.396	0.025
	Non-beta blocker	26.9±5.7	31.3±5.8^†‡	31.2±5.9^‡
RPE	Beta blocker	11.7±2.6	8.9±1.9	9.4±2.8	3.900	0.843
	Non-beta blocker	11.3±2.9	8.3±1.8	8.5±1.9

Values are presented as mean±standard deviation. HR: heart rate, MRPP: maximal rate pressure product, RPP: rate pressure product, RPE: rate of perceived exertion. Maximum oxygen uptake, ∗Two-way (time×treatment) repeated-measure ANOVA interaction effect at p＜0.05,

^† signi-ficantly different from the control group at p＜0.05,

^‡ significantly different from 1st trial,

^§ different from the control group at p=0.067.

Table 3.

Change of blood lipid profile over time

		1 time	2 time	3 time	F-value	p-value
Total cholesterol	Beta blocker	178±42	155±36	154±34	1.446	0.242
	Non-beta blocker	173±31	157±31	164±31
Triglyceride	Beta blocker	154±89.1	131±57.7	163±64.9	0.192	0.826
	Non-beta blocker	152±91.6	137±58.5	154±116.1
HDL	Beta blocker	43.3±6.4	45.3±6.9	43.4±10.3	0.473	0.625
	Non-beta blocker	41.2±14.8	42.1±10.7	43.1±7.6
LDL	Beta blocker	108±30	81±26	82±30	0.193	0.825
	Non-beta blocker	112±28	87±28	92±29

Values are presented as mean±standard deviation. HDL: high density lipidemia, LDL: low density lipidemia.

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