Effects of new inotropic agents on exercise performance

Karl Weber, J. S. Janicki, C. S. Maskin

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Symptoms of dyspnea and fatigue limit effort tolerance in patients with chronic cardiac failure. These symptoms may be consequent to an abnormal cardiocirculatory response to the increased O2 demand that accompanies exercise as manifested by: (1) reduced ability to augment cardiac output in response to increased left ventricular filling pressure, (2) inadequate vasodilatory response in exercising limbs, (3) the onset of lactate production by muscle at relatively low levels of work, and (4) increased work of breathing that accompanies pulmonary venous hypertension and abnormal compliance of the lung secondary to left ventricular dysfunction. The clinical experience with new positive inotropic agents in the long-term treatment of patients with chronic cardiac failure is accumulating rapidly. Attention has focused on the ability of these agents to improve exercise performance, particularly their ability to increase the aerobic capacity. The experience to date suggest that β-adrenergic receptor agonists offer little advantage in this regard while causing ventricular arrhythmias. On the other hand, the phosphodiesterase inhibitors, MDL 17,043 and MDl 19,205, and the bipyridine derivatives, amrinone and milrinone, may improve exercise performance in many patients and exert a sustained effect during long-term therapy. Placebo-controlled, randomized trials will need to be performed, however, to determine the ultimate efficacy and safety of these agents. The most meaningful results for analysis will be obtained when objective parameters of exercise performance, such as aerobic capacity and anaerobic threshold, are monitored that are free of patient or physician bias.

Original languageEnglish (US)
JournalCirculation
Volume73
Issue number3 II MONOGR. 120
StatePublished - Jan 1 1986

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Exercise
Enoximone
Heart Failure
Amrinone
Milrinone
Work of Breathing
Anaerobic Threshold
Lung Compliance
Adrenergic Agonists
Phosphodiesterase Inhibitors
Left Ventricular Dysfunction
Ventricular Pressure
Pulmonary Hypertension
Cardiac Output
Dyspnea
Fatigue
Cardiac Arrhythmias
Lactic Acid
Extremities
Randomized Controlled Trials

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Weber, K., Janicki, J. S., & Maskin, C. S. (1986). Effects of new inotropic agents on exercise performance. Circulation, 73(3 II MONOGR. 120).

Effects of new inotropic agents on exercise performance. / Weber, Karl; Janicki, J. S.; Maskin, C. S.

In: Circulation, Vol. 73, No. 3 II MONOGR. 120, 01.01.1986.

Research output: Contribution to journalReview article

Weber, K, Janicki, JS & Maskin, CS 1986, 'Effects of new inotropic agents on exercise performance', Circulation, vol. 73, no. 3 II MONOGR. 120.
Weber K, Janicki JS, Maskin CS. Effects of new inotropic agents on exercise performance. Circulation. 1986 Jan 1;73(3 II MONOGR. 120).
Weber, Karl ; Janicki, J. S. ; Maskin, C. S. / Effects of new inotropic agents on exercise performance. In: Circulation. 1986 ; Vol. 73, No. 3 II MONOGR. 120.
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