scholarly journals Dosing study of esmolol for reducing hemodynamic changes during lightwand intubation

2020 ◽  
Vol 15 (4) ◽  
pp. 417-423
Author(s):  
Jin Ku Kang ◽  
Sie Hyeon Yoo ◽  
Jin Hun Chung ◽  
Nan Seol Kim ◽  
Ho Soon Jung ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Normal Saline ◽  
Elective Surgery ◽  
Rate Pressure Product ◽  
Hemodynamic Changes ◽  
Direct Stimulation ◽  
Before And After ◽  
Different Doses ◽  
Stimulation Of

Background: Lightwand is a convenient tool that can be used instead of a laryngoscope for intubation. Tracheal intubation causes direct stimulation of the larynx, drastically increasing hemodynamic values including blood pressure and heart rate. This study aims to identify the effect of different doses of esmolol on hemodynamic changes during lightwand intubation.Methods: The study subjects included 140 patients who underwent general anesthesia for elective surgery. The patients were randomly divided into four groups (35 patients in each group). The ‘C’ group only received 20 ml of normal saline, while the ‘E0.5’, ‘E1’, and ‘E2’ groups received 20 ml of normal saline containing esmolol—0.5 mg/kg, 1 mg/kg, and 2 mg/kg, respectively, injected 2 min prior to intubation. The patients’ blood pressure, heart rate, and rate-pressure product were measured six times, before and after the intubation.Results: The degree of heart rate elevation was suppressed in the E1 and E2 groups compared to the C group, and RPP after intubation significantly decreased in the E2 group compared to the C group.Conclusions: 1–2 mg/kg of a single esmolol injection prior to lightwand intubation effectively blunts heart rate elevation, and 2 mg/kg of esmolol injection blunts rate-pressure product elevation.

scholarly journals EFEK PREMEDIKASI MIDAZOLAM 0,05 MG/KGBB IV TERHADAP TEKANAN DARAH dan LAJU NADI

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Marlin Matana ◽  
Mordekhai Laihad ◽  
Harold Tambajong
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Pulse Rate ◽  
Analytical Study ◽  
Elective Surgery ◽  
Sample Selection ◽  
Significant Drop ◽  
Before And After ◽  
Test Result ◽  
Midazolam Premedication

Abstrak: Operasi merupakan tindakan yang banyak menimbulkan kecemasan. Hal tersebut menyebabkan timbulnya respons stres, dengan akibat dapat terjadinya peningkatan tekanan darah dan laju nadi. Midazolam  merupakan obat premedikasi yang mampu menurunkan tingkat kecemasan. Peningkatan  tekanan darah dan laju nadi akibat stres psikologi sebelum menghadapi tindakan operasi, dapat mempengaruhi kondisi yang tidak menguntungkan. Tujuan: Untuk mengetahui  perubahan tekanan darah dan laju nadi pada pasien setelah premedikasi  Midazolam 0,05 mg/kgbb IV. Metode penelitian: Penelitian ini merupakan penelitian analitik prospektif. Sampel ialah 25 pasien yang menjalani bedah elektif.  Cara pemilihan sampel dilakukan dengan accidental sampling. Uji statitik menggunakan uji t berpasangan. Hasil penelitian: Tekanan darah sistolik, diastolik, pada pasien sebelum dan sesudah premedikasi Midazolam  menit ke lima dan sepuluh terdapat perbedaan yang bermakna (p <0,05), sedangkan laju nadi pasien sebelum premedikasi dan sesudah premedikasi  menit ke lima dan sepuluh terdapat perbedaan yang tidak bermakna (p > 0,05). Simpulan: Pemberian premedikasi Midazolam 0,05 mg/kgbb IV, dapat memperlihatkan penurunan tingkat ansietas pasien yang dapat dilihat dari penuruan  tekanan darah yang bermakna namun penuruan laju nadi tidak bermakna. Kata kunci: Midazolam 0,05 mg/kgbb iv, kecemasan, tekanan darah, laju nadi. Abstract: Surgery is the treatment measurement thet generated a lot of anxiety. This causes the onset of the stress response, with the result can be an increase blood pressure and heart rate. Midazolam premedication is a drug that can reduce the level of anxiety. The change in pulse rate and blood pressure  to be high due psychological stress, before facing surgery can affect unfavorable conditions. Purpose:  To know the change of blood pressure and heart rate to patient who take premedication Midazolam 0,05 mg/kgbb IV. Methods: This research is a prospective analytical study. The sample is 25 patients who have elective surgery. Sample selection method is done by accidental sampling. Statistic test using a paired t test. Result: Systolic and diastolic blood pressure were measured in patients before and after midazolam premedication and ten minutes to five, there is a significicant difference (p < 0,05 ), whereas the patien’s heart rate before and after premedication at minute five and ten there were no significant differences (p < 0,05 ) Conclution: By providing premedication Midazolam 0.05 mg/kg, may show decreased levels of anxiety patients that can be seen from the significant drop in blood pressure and pulse rate were not significant. Keyword: Midazolam 0,05 mg/kgbb iv, anxiety, blood pressure, heart rate.

scholarly journals Intravenous dexmedetomidine 1µg/kg as premedication to attenuate hemodynamic response to laryngoscopy and endotracheal intubation in surgeries under general anesthesia

2017 ◽  
Vol 4 (6) ◽  
pp. 1884
Author(s):  
Dixitkumar B. Modh ◽  
Pratiti Gohil ◽  
Manthan Parmar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Induction Agent ◽  
Hemodynamic Parameters ◽  
Hemodynamic Changes ◽  
Dose Requirement ◽  
Hemodynamic Stability ◽  
Induction Dose

Background: Choice of premedication and hemodynamic stability are always remain important concerns during laryngoscopy and endotracheal intubation for Anesthesiologists. Dexmedetomidine offers anxiolytic, sedation, hypnosis, analgesia, antisialagogue action as well as sympatholysis which make most suitable drug as premedication. Our aims for this study to evaluate efficacy of Injection Dexmedetomidine 1µg/kg intravenously as premedication on attenuation of hemodynamic changes to laryngoscopy and intubation as well as requirement of injection Propofol as an induction agent.Methods: In Present study, 60 patients of ASA I, II of age 18 to 45 years were randomly divided in to two groups of 30 each. In group NS, 10 ml normal saline and in group D1 injection Dexmedetomidine 1µg/kg diluted in 10 ml of normal saline was used. In both groups study solutions administered over 10 minutes. Both the groups were administered standard general anaesthesia and requirement of Propofol was noted as an induction agent. Heart rate, blood pressure (systolic, diastolic and mean arterial pressure) were compared at baseline, 2 min, 5 min, 10 minutes (SD2, SD5, SD10) after study drugs administration, before induction (BI), after induction (AI), 1 minute (T1), 2 minutes (T2), 5 minutes (T5) and 10 minutes (T10) after laryngoscopy and intubation in both groups.Results: HR, SBP, DBP and MAP highly significantly reduced at 2 min, 5 min and 10 minutes after infusion of Dexmedetomidine in group D1 as compared to group NS. (P<0.01). After induction values are highly significant in group D1 than group NS from baseline (P<0.01). Highly significant mean rise in hemodynamic parameters (HR, SBP, DBP and MAP) from baseline were observed in group NS compared to group D1 after laryngoscopy and intubation (P<0.01). Induction dose requirement of inj. Propofol significantly reduced in group D1 compared to other group (P<0.01).Conclusions: Injection Dexmedetomidine 1µg/kg provides effective and complete attenuation of pressure response to laryngoscopy and endotracheal intubation as premedication with decreased requirement of inj. Propofol for induction without any side effects.

scholarly journals Reflex cardiovascular responses originating in exercising muscles of mice

2001 ◽  
Vol 90 (2) ◽  
pp. 579-585 ◽  
Author(s):  
Jeffery M. Kramer ◽  
Arthur Aragones ◽  
Tony G. Waldrop
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Muscle Contraction ◽  
Cardiovascular Responses ◽  
Muscular Contraction ◽  
Dependent Manner ◽  
Direct Stimulation ◽  
Systemic Hypoxia ◽  
Dose Dependent ◽  
Stimulation Of

The cardiovascular responses induced by exercise are initiated by two primary mechanisms: central command and reflexes originating in exercising muscles. Although our understanding of cardiovascular responses to exercise in mice is progressing, a murine model of cardiovascular responses to muscle contraction has not been developed. Therefore, the purpose of this study was to characterize the cardiovascular responses to muscular contraction in anesthetized mice. The results of this study indicate that mice demonstrate significant increases in blood pressure (13.8 ± 1.9 mmHg) and heart rate (33.5 ± 11.9 beats/min) to muscle contraction in a contraction-intensity-dependent manner. Mice also demonstrate 23.1 ± 3.5, 20.9 ± 4.0, 21.7 ± 2.6, and 25.8 ± 3.0 mmHg increases in blood pressure to direct stimulation of tibial, peroneal, sural, and sciatic hindlimb somatic nerves, respectively. Systemic hypoxia (10% O2-90% N2) elicits increases in blood pressure (11.7 ± 2.6 mmHg) and heart rate (42.7 ± 13.9 beats/min), while increasing arterial pressure with phenylephrine decreases heart rate in a dose-dependent manner. The results from this study demonstrate the feasibility of using mice to study neural regulation of cardiovascular function during a variety of autonomic stimuli, including exercise-related drives such as muscle contraction.

β2 Adrenoceptor (ADRB2) Pharmacogenetics and Cardiovascular Phenotypes during Laryngoscopy and Tracheal Intubation

2006 ◽  
Vol 25 (6) ◽  
pp. 443-449 ◽  
Author(s):  
Çetin Kaymak ◽  
Neslihan Aygün Kocabaş ◽  
Emre Durmaz ◽  
Derya Öztuna
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Tracheal Intubation ◽  
Rate Pressure Product ◽  
Nucleotide Polymorphisms ◽  
Hemodynamic Changes ◽  
Single Nucleotide ◽  
Peripheral Vasodilatation ◽  
Genes Encoding ◽  
Allele Specific

Pharmacogenetics is the study of genetic variations that cause a variable drug response characterized by alteration in drug metabolism or in pharmacodynamics. The polymorphisms in genes encoding receptors relevant to treatment cause variation in sensitivity to many drugs. β2 Adrenoceptor genetic variation contributes to regulation of blood pressure and hemodynamic changes by mediating peripheral vasodilatation. Laryngoscopy and tracheal intubation associated with hemodynamic changes. Although there are four nonsynomic single-nucleotide polymorphisms (SNPs) of β2 adrenoceptor gene, codon 16 (Arg16Gly) and codon 27 (Gln27Glu) SNPs are both common and functionally important. In this paper, the authors investigated the β2 adrenoceptor Gly16 and Glu27 SNPs in response to drugs relevant to anesthesia and how these SNPs impacted upon the cardiovascular phenotypes. The authors measured arterial systolic and diastolic blood pressure, heart rate, and rate-pressure product before induction of anesthesia and 1 min following laryngoscopy and tracheal intubation. Genomic DNA was amplified and genotyped using allele-specific polymerase chain reaction (ASPCR) and restriction fragment length polymorphism (RFLP) assays, respectively. When the authors compared hemodynamic results according to genotypes, the patients with Gln homozygote allele at codon 27 exhibited significant increase of heart rate than patients with Glu allele after laryngoscope and tracheal intubation.

scholarly journals Effect of Two Different Doses of Gabapentin on the Intraocular Pressure and Hemodynamic Stress Responses to Laryngoscopy and Tracheal Intubation

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Amani A. Ali ◽  
Abeer M. Elnakera ◽  
Ahmed Samir
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Intraocular Pressure ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Tracheal Intubation ◽  
Stress Responses ◽  
Group I ◽  
Before And After ◽  
Different Doses

Background. The stress response to laryngoscopy and intubation causes an undesirable increase in heart rate, blood pressure, and intraocular pressure. This study was designed to compare the effect of two doses of gabapentin on the stress response to laryngoscopy and intubation. Patients and Methods. (ASA I and II) 60 patients, aged from 18 to 60 years undergoing elective eye surgery requiring endotracheal intubation, were randomly allocated into 3 groups, 20 patients each. 2 hours before the surgery, group I received oral placebo, and groups II and III received oral gabapentin 800 mg and 1200 mg, respectively. Heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP) were measured before and after induction of anesthesia, immediately after, 5 minutes, and 10 minutes after intubation. Results. Gabapentin 1200 mg prevented the increase in HR, MAP, and IOP, secondary to laryngoscopy and intubation, and kept them below the baseline till 10 minutes after intubation (), while with gabapentin 800 mg, the increase in HR, MAP, and IOP was nonsignificant () and returned to levels below the baseline at 5 and 10 minutes after intubation. Conclusion. Preoperative gabapentin 1200 mg effectively prevented the stress response to laryngoscopy and intubation; meanwhile, gabapentin 800 mg only prevented significant stress response.

Hemodynamic Changes with 1:1000 Epinephrine on Wrung-Out Pledgets Before and During Sinus Surgery

2020 ◽  
pp. 000348942095910
Author(s):  
John R. Peleman ◽  
Pritee Tarwade ◽  
Xiaoxia Han ◽  
Donald H. Penning ◽  
John R. Craig
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Intraoperative Complications ◽  
Sinus Surgery ◽  
Hemodynamic Changes ◽  
Level Of Evidence ◽  
Intranasal Application ◽  
Estimated Blood Loss ◽  
Before And After ◽  
Clinically Significant

Background: Intranasal topical 1:1000 epinephrine has been used safely and effectively for hemostasis during endoscopic sinus surgery (ESS). Prior studies assessing hemodynamic changes after intranasal topical epinephrine application have only used soaking wet cottonoid pledgets, and have only assessed for hemodynamic changes before any surgery being performed. Objective: The purposes of this study were to determine whether intranasal application of topical 1:1000 epinephrine with wrung-out cottonoid pledgets caused significant hemodynamic changes both before and during ESS, and whether it allowed for adequate hemostasis. Methods: A prospective evaluation of 30 patients with eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) undergoing complete bilateral ESS was conducted. Heart rate, blood pressure (systolic, diastolic, and mean arterial pressure), and electrocardiography changes were recorded at 0, 1, 2, and 5-minute intervals after placing wrung-out epinephrine-saturated pledgets, both before and at the end of ESS. No submucosal epinephrine injections were performed. Estimated blood loss (EBL) and major intraoperative complications were recorded for all cases. Results: There were no significant hemodynamic changes or electrocardiographic abnormalities after placement of wrung-out epinephrine-soaked pledgets both before and after ESS. After bilateral ESS, there were actually mean decreases in heart rate and blood pressure parameters. Mean EBL was 75.8 ± 32.2 mL, and no major intraoperative complications occurred. Conclusion: Intranasal application of topical 1:1000 epinephrine via wrung-out cottonoid pledgets was effective for intraoperative hemostasis, and did not cause clinically significant alterations in hemodynamic parameters or cardiovascular events, either before or during ESS in patients with CRSwNP. Level of Evidence: 4

scholarly journals Clinical efficacy of dexmedetomidine in two different doses to attenuate the hemodynamic changes during laparoscopic cholecystectomy

2018 ◽  
Vol 6 (3) ◽  
pp. 959
Author(s):  
Tahir Ahamad Masoori ◽  
Kumkum Gupta ◽  
Salony Agarwal ◽  
Manoranjan Bansal ◽  
Azka Zuberi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Side Effects ◽  
Clinical Efficacy ◽  
Hemodynamic Changes ◽  
Maintenance Infusion ◽  
Group 2 ◽  
Dexmedetomidine Infusion ◽  
Different Doses

Background: Laryngoscopy and laparoscopy lead to predictable hemodynamic changes. Dexmedetomidine is selective 2 agonist with dose dependent sedation, sympatholysis and analgesia, hence could provide stable hemodynamics during laparoscopic surgeries. The present study was aimed to compare the clinical efficacy of dexmedetomidine infusion in two different doses to attenuate the hemodynamic variations during laparoscopic cholecystectomy.Methods: Total 60 adult patients of ASA physical status I and II of both gender, scheduled for elective laparoscopic cholecystectomy, were randomly allocated into two groups of 30 patients. All patients were infused with loading dose of dexmedetomidine (1µg/kg) before induction. Patients of Group 1 received maintenance infusion of dexmedetomidine in doses of 0.3µg/kg/h and patients of Group 2 received maintenance infusion of dexmedetomidine in doses of 0.6µg/kg/h, continued till the end of surgery. Heart rate and blood pressure were recorded preoperatively, after dexmedetomidine administration, after induction, intubation, after creation of pneumoperitoneum and postoperatively. Intraoperative changes in heart rate and blood pressure were noted as primary variables and dexmedetomidine related side effects were noted as secondary outcomes, for statistical analysis.Results: The hemodynamic responses were attenuated in patients of both groups after laryngoscopy, intubation and creation of pneumoperitoneum but patients of Group 2 (0.6µg/kg/h) showed more stability in hemodynamics. The difference between the group was statistically significant (p value=0.001). No any evident complication or side effects occurred.Conclusions: Dexmedetomidine infusion was effective for attenuating the hemodynamic changes due to laryngoscopy and laparoscopy but were better with maintenance infusion of dexmedetomidine in dose of 0.6µg/kg/h. 

scholarly journals Comparison of Intravenous Lignocaine and Dexmedetomidine for Attenuation of Hemodynamic Stress Response to Laryngoscopy and Endotracheal Intubation

2021 ◽  
Vol 10 (16) ◽  
pp. 1123-1129
Author(s):  
Deepti N. Anandani ◽  
Manisha S. Kapdi ◽  
Ami D. Patel ◽  
Pratik Jain
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Rate Pressure Product

BACKGROUND The purpose of the present study was to evaluate the efficacy of intravenous lignocaine 1.5 mg / kg & intravenous dexmedetomidine 1 mcg / kg for attenuating the haemodynamic response to laryngoscopy & endotracheal intubation in patients undergoing elective surgery under general anaesthesia. METHODS In this prospective randomised, comparative, clinical study, 60 patients were randomly divided into 2 groups, among them 30 patients were given infusion of 1.5 mg / kg IV lignocaine, diluted to 10 ml with normal saline, 3 minutes before intubation & 30 patients were given infusion of dexmedetomidine 1 mcg / kg diluted to 25 ml in normal saline over 10 minutes through infusion pump before induction. The heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, rate pressure product, oxygen saturation were measured at baseline, after study drug intubation at L + 1, L + 3, L + 5, L + 7 & L + 10 (L is onset of laryngoscopy). Statistical analysis was done by using descriptive & inferential statistics using chisquare test, Students paired & unpaired t test to find out the significance of the five variables namely mean heart rate (HR), mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean arterial pressure (MAP) and mean rate pressure product (RPP). RESULTS Dexmedetomidine provided better blunting of stress response during laryngoscopy and intubation without causing clinically significant respiratory depression, bradycardia or hypotension. It is better in achieving a low RPP, which is a good predictor of myocardial oxygen consumption. Dexmedetomidine provides better cardio-protection in patients against pressure response than lignocaine. CONCLUSIONS In these 60 patients, dexmedetomidine (1 mcg / kg) was found to be superior to lignocaine (1.5 mg / kg) for attenuation of pressor response. KEY WORDS Laryngoscopy, Endotracheal Intubation, Dexmedetomidine, Lignocaine, Rate Pressure Product

scholarly journals Use of Gabapentin, Esmolol or Their Combination to Attenuate Haemodynamic Response to Laryngoscopy and Intubation

2012 ◽  
Vol 9 (4) ◽  
pp. 238-243 ◽  
Author(s):  
G S Shrestha ◽  
M N Marhatta ◽  
R Amatya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Normal Saline ◽  
Study Drug ◽  
Haemodynamic Response ◽  
Rate Pressure Product ◽  
Significant Difference

Background Laryngoscopy and intubation increases blood pressure and heart rate. Objective The study aims to investigate the effect and safety of gabapentin, esmolol or their combination on the haemodynamic response to laryngoscopy and intubation. Methods A total of 72 patients undergoing elective surgery were randomly allocated to one of the four groups. First study drug was administered orally as gabapentin 1200mg or placebo. Second study drug was administered intravenously as esmolol 1.5mg/kg or normal saline. Heart rate, rate pressure product, systolic blood pressure and mean arterial pressure were recorded at baseline and at zero, one, three and five minutes after tracheal intubation. Results Baseline values were compared with the values at various time intervals within the same group. In group PE (placebo, esmolol), there was significant decrease in heart rate and rate pressure product at five minutes. In group GN (gabapentin, normal saline), there was significant decrease in systolic blood pressure and mean arterial pressure at five minutes. In group GE (gabapentin, esmolol), there was significant decrease in heart rate at zero, three and five minutes. Systolic blood pressure, mean arterial pressure and rate pressure product was significantly lower at three and five minutes. In group PN (placebo, normal saline), there was significant increase in heart rate at zero, one, three and five minutes; systolic blood pressure at zero and one minutes; mean arterial pressure at zero and one minutes & rate pressure product at zero, one and three minutes. In group GN (gabapentin, normal saline), there was significant increase in heart rate at zero, one and three minutes & rate pressure product at zero, one and three minutes. In group PE (placebo, esmolol), there was significant increase in systolic blood pressure at zero and one minutes & mean arterial pressure at zero and one minutes. However, in group GE (gabapentin, esmolol) none of the variables showed statistically significant increase at any time. Inter-group comparison was made for each time point. At zero minute, there was significant difference in heart rate between groups PN and GE, GN and PE & GN and GE Significant difference was also noted in rate pressure product between PN and GE at zero minute. At one minute there was difference in heart rate between PN and PE, PN and GE, GN and PE & between GN and GE. Significant difference was observed in rate pressure product between PN and PE & between PN and GE at one minute. No significant side effects of the study drugs were observed. ConclusionsCombination of gabapentin and esmolol in this study design is safe and better attenuates both the pressor and tachycardic response to laryngoscopy and intubation, than either agent alone.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6336 Kathmandu Univ Med J 2011;9(4):238-43 

Catecholamines in coronary sinus during exercise in man before and after training

1977 ◽  
Vol 43 (5) ◽  
pp. 801-806 ◽  
Author(s):  
D. Cousineau ◽  
R. J. Ferguson ◽  
J. de Champlain ◽  
P. Gauthier ◽  
P. Cote ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Coronary Sinus ◽  
Physical Training ◽  
Plasma Catecholamines ◽  
Rate Pressure Product ◽  
Additional Increase ◽  
Before And After ◽  
Coronary Patients

Coronary patients exercised on an ergometric bicycle before and after physical training. Plasma catecholamines were sampled simultaneously at the arterial and coronary sinus levels and assayed with a radioenzymatic method. The increase in the level of coronary sinus catecholamines exceeded the increase in the arterial level, indicating a liberation of catecholamines by the myocardium and an activation of the peripheral sympathetic fibers during exercise. With high work loads, these values no longer differed, suggesting that the additional increase in circulating catecholamines originate from extra-myocardial stores, presumably the adrenal medulla. Arterial catecholamine levels were significantly correlated with work loads, heart rate, changes in systolic blood pressure, and rate-pressure product. After physical training, arterial catecholamine increases for various work loads were lower; these lower elevations were associated with diminished responses in heart rate and systolic blood pressure, resulting in a lower rate-pressure product. Physical training results in diminished sympathetic responses for a given level of exercise, which could be associated with the clinical improvement of these patients.

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