NONSELECTIVE BETA-ADRENERGIC-BLOCKADE WITH CARVEDILOL DOES NOT HINDERTHE BENEFITS OF EXERCISE TRAINING IN PATIENTS WITH CONGESTIVE-HEART-FAILURE

Background Long-term beta-adrenergic blockade does not appear to be as sociated with drug-induced training in patients with congestive heart failure (CHF) whether exercise training can increase peak aerobic capa city In patients with CHF who are treated with beta-adrenergic blocker s is currently unknown. Methods and Results We studied 23 patients wit h CHF who were treated with cavredilol or propranolol in addition to A CE inhibitors, furosemide, and digoxin. Of the patients treated with c arvedilol, 8 underwent exercise training and 8 remained sedentary. All 7 patients treated with propranolol underwent exercise training. Peak oxygen consumption (mL . kg(-1). min(-1)) was serially measured in tr ained and sedentary patients. Peak reactive hyperemia (mL . min(-1). 1 00 mL(-1)) was determined in the calf and forearm immediately before a nd after 12 weeks of training. The peak oxygen consumption of trained patients treated with either carvedilol or propranolol increased from 12.9+/-1.4 to 16.0+/-1.6 (P<.001) and 12.4+/-1.0 to 15.7+/-0.9 (P<.001 ) mL . kg(-1). min(-1), respectively, whereas it did not change in the sedentary patients. Peak reactive hyperemia increased significantly i n the calves but not the forearms of trained patients. Conclusions Lon g-term, nonselective beta-adrenergic blockade with carvedilol or propr anolol does not prevent patients with CHF from deriving systemic and r egional benefits rom physical training.