Differential Effect of β-Blockers for Heart Rate Control in Coronary Artery Disease

Systemic inflammation is associated with sympathetic cardiac activation and decreased HRV (heart rate variability) in subjects at high risk of CAD (coronary artery disease). In the present study, we examined the influence of systemic inflammation, measured by CRP (C-reactive protein), on vagal HR (heart rate) control during behavioural relaxation in patients with CAD. It was hypothesized that CRP would be associated with decreased vagal HR modulation. Consecutive patients were screened 2 weeks prior to elective PTCA (percutaneous transluminal coronary angioplasty). The study was comprised of 29 subjects who represented the first and fourth quartiles of the CRP distribution: Low (0.47±0.07 μg/ml)- and High (8.19±1.95 μg/ml)-CRP groups respectively. Vagal HR control was quantified as RR high-frequency spectral power (0.15 to 0.40 Hz), and was assessed in log-transformed absolute units (logHF power). Near-IR particle immunoassay was used to determine high-sensitivity CRP concentration. Assessment entailed 5 min of silent reading and self-guided behavioural relaxation. RR logHF power was decreased in the High-CRP group across both assessment procedures (P=0.032). Behavioural relaxation increased RR logHF power for both the Low- and High-CRP groups (P=0.033). Hierarchical linear regression determined that CRP accounted for 18.9% of the variance in RR logHF power during behavioural relaxation (P=0.03), independent of baseline RR interval, cardiac medication, respiratory logHF power and body mass index. In conclusion, patients with CAD had augmented vagal HR control with behavioural relaxation, but this effect was moderated by the severity of CRP. Therefore it may be advisable to assess systemic inflammation in interventions aimed at improving neurocardiac regulation in patients with CAD.

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Heart rate control is associated with reduced cardiovascular events in Asian patients with coronary artery disease treated with bisoprolol (BISO-CAD): results from a multi-national, real-world experience

Current Medical Research and Opinion ◽

10.1080/03007995.2017.1363729 ◽

2017 ◽

Vol 34 (2) ◽

pp. 217-225 ◽

Cited By ~ 2

Author(s):

Yundai Chen ◽

Xinchun Yang ◽

Vinh Nguyen Pham ◽

Shian Huang ◽

Guosheng Fu ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Coronary Artery ◽

Real World ◽

Rate Control ◽

Cardiovascular Events ◽

Heart Rate Control ◽

Asian Patients ◽

Artery Disease

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Resting heart rate control and prognosis in coronary artery disease patients with hypertension previously treated with bisoprolol

Chinese Medical Journal ◽

10.1097/cm9.0000000000000802 ◽

2020 ◽

Vol 133 (10) ◽

pp. 1155-1165

Author(s):

Yun-Dai Chen ◽

Xin-Chun Yang ◽

Vinh Nguyen Pham ◽

Shi-An Huang ◽

Guo-Sheng Fu ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Coronary Artery ◽

Rate Control ◽

Resting Heart Rate ◽

Heart Rate Control ◽

Previously Treated ◽

Artery Disease

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Heart rate and other risk factors in outpatients with stable coronary artery disease in Latvia

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.2478/v10046-011-0024-2 ◽

2011 ◽

Vol 65 (3-4) ◽

pp. 94-101

Author(s):

Inga Balode ◽

Sanda Jēgere ◽

Iveta Mintāle ◽

Inga Narbute ◽

Gustavs Latkovskis ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Heart Rate ◽

Coronary Artery ◽

Angiotensin Receptor Blockers ◽

Stable Coronary Artery Disease ◽

Pulse Palpation ◽

Co Morbidity ◽

Β Blockers ◽

Artery Disease

Heart rate and other risk factors in outpatients with stable coronary artery disease in Latvia The aim of the study was to characterise coronary artery disease (CAD) outpatients in Latvia by risk factors (RF) including heart rate (HR), physical examination data, clinical data and treatment. Twelve practitioners had each examined and questioned 6 to 12 patients with established CAD (n = 120). The most frequent cardiovascular (CV) RF and co-morbidity were dyslipidemia (94.2%) and hypertension (78.3%), respectively. Prevalence of increased resting HR (≥70 bpm) was 35.9% and 33.6%, when measured by pulse palpation and electrocardiography, respectively. Regarding other RFs, prevalence of treated but insufficiently controlled blood pressure 140/90 mmHg, total cholesterol 1 > 5 mmol/l and triglycerides > 1.7 mmol/l was 25.8%, 30.1% and 33.3%, respectively. Aspirin, statins and angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers were used in 96.7%, 94.2% and 85.0% of cases, respectively. Beta blockers were used in 81.7% of cases. Average daily doses of most frequently used β blockers (metoprolol and bisoprolol) were 32% and 53% from target doses, respectively. In three cases β blockers were combined with ivabradin. Our results suggest that practitioners follow guidelines and consider CV prevention by treating CAD patients. Our data identified, however, unused potential for better control of increased HR by higher doses and combinations of HR-reducing agents.

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Β-blockers: the lack of taskimplementation or the unwillingness of doctors in the russian federation to optimize the treatment?

Systemic Hypertension ◽

10.26442/sg29012 ◽

2014 ◽

Vol 11 (1) ◽

pp. 56-63

Author(s):

I V Fomin ◽

D S Polyakov

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Coronary Artery ◽

Russian Federation ◽

Representative Sample ◽

Clinical Manifestations ◽

The Russian Federation ◽

Β Blockers ◽

Artery Disease ◽

Almost All

The purpose of the study. The achievedheart rate of 50-60 beats per minute in patients after acute myocardial infarction, and up to50-70 beats per minute for patients with stable angina is considered effective. Assuming that in Russia low doses of β-blockers are often used, thequestion was raised: «How common tachycardia can bein patients with coronary heart disease (CHD) and chronic heart failure (CHF), and whether there are strategic approaches to achieving the targets in heart rate in these patients in real clinical practice and are β-blockers often used in patients for whom this group of drugs is the basic one?»Materials and Methods. Work carried out in the framework of the Russian epidemiological study of a representative sample of the European partof the Russian Federation. All patients with CHF and coronary artery disease were divided into two subgroups: heart rate reducers not receiving medicines and receiving at least one heart rate reducing drug (a β-blocker, calcium channel 1 and 3rd type (AK) blockers, glycosides).Results and discussion. In a representative sample of the program in healthy individuals (without clinical manifestations of coronary arterydisease) tachycardia was diagnosed in 7,1% of cases. Almost all respondents without CHD (87,3%) had normal heart rate from 61 to 80 beats per minute. Number of respondents without CHD with heart rate of 70 to 79 bpm. per min. (54,1%) turned out to be significantly less than that of patients with rhythm in any form of coronary artery disease (p

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