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Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines

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Resumo:Objective: There is a well known association between mitral valve prolapse (MVP) and low blood pressure (BP), although patients often have high levels of catecholamines and high heart rate (HR). The main objective of our study was to evaluate the effects of long-term adrenergic beta-blockade on these parameters. Methods: The study population consisted of 46 patients with MVP and the control group consisted of 20 normal individuals. The study had two phases: in the first phase, patients were free of medications. In the second phase, patients were under treatment with propranolol for 10 to 12 months. The tests were performed in normal individuals and patients in the first phase. Only patients underwent the same tests in the second phase. Measurement of urinary epinephrine and norepinephrine levels, by high performance liquid chromatography, was done. Rest HR was determined by electrocardiogram (ECG), and ambulatory blood pressure and HR were evaluated by 24 hours ambulatory blood pressure monitoring (ABPM) using the auscultatory method. Results: The levels of epinephrine and norepinephrine were significantly higher in patients than in normal controls and decreased under propranolol. Rest and ambulatory HR were higher in patients and decreased under propranolol. The 24 hours systolic and diastolic BPs were lower in patients, and their values increased under propranolol. Heart rate decreasing and epinephrine levels reduction were positively correlated. No correlation was found between BP increase and catecholamine levels. Conclusion: The study results show divergent effects of propranolol on blood pressure, which increased, and on heart rate, that decreased, in patients with MVP. Heart rate decrease was an expected result and depends, namely, on b1 receptors blockade. Increase in BP is an unusual response to adrenergic beta-blockade in normal conditions, and this finding supports the preponderance of b2 receptors on the BP control in patients with MVP.
Autores principais:da Silva, Emilia Pereira
Outros Autores:Mendes Pedro, Mónica; Varela, Manuel Gato; Cortez-Dias, Nuno; Bicho, Manuel; Madeira, Hugo; Lopes, Mario G.
Assunto:Mitral valve prolapse Blood pressure Heart rate Beta-blockade
Ano:2007
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Universidade de Lisboa
Idioma:inglês
Origem:Repositório da Universidade de Lisboa
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author da Silva, Emilia Pereira
author2 Mendes Pedro, Mónica
Varela, Manuel Gato
Cortez-Dias, Nuno
Bicho, Manuel
Madeira, Hugo
Lopes, Mario G.
author2_role author
author
author
author
author
author
author_facet da Silva, Emilia Pereira
Mendes Pedro, Mónica
Varela, Manuel Gato
Cortez-Dias, Nuno
Bicho, Manuel
Madeira, Hugo
Lopes, Mario G.
author_role author
contributor_name_str_mv Repositório Científico de Acesso Aberto da ULisboa
country_str PT
creators_json_txt [{\"Person.name\":\"da Silva, Emilia Pereira\"},{\"Person.name\":\"Mendes Pedro, Mónica\",\"Person.identifier.orcid\":\"0000-0002-2782-4398\"},{\"Person.name\":\"Varela, Manuel Gato\"},{\"Person.name\":\"Cortez-Dias, Nuno\",\"Person.identifier.orcid\":\"0000-0002-9244-4631\"},{\"Person.name\":\"Bicho, Manuel\",\"Person.identifier.orcid\":\"0000-0002-5773-5687\"},{\"Person.name\":\"Madeira, Hugo\",\"Person.identifier.orcid\":\"0000-0003-4291-2289\"},{\"Person.name\":\"Lopes, Mario G.\",\"Person.identifier.orcid\":\"0000-0002-2855-5118\"}]
datacite.contributors.contributor.contributorName.fl_str_mv Repositório Científico de Acesso Aberto da ULisboa
datacite.creators.creator.creatorName.fl_str_mv da Silva, Emilia Pereira
Mendes Pedro, Mónica
Varela, Manuel Gato
Cortez-Dias, Nuno
Bicho, Manuel
Madeira, Hugo
Lopes, Mario G.
datacite.date.Accepted.fl_str_mv 2007-07-01T00:00:00Z
datacite.date.available.fl_str_mv 2021-05-14T15:36:25Z
datacite.date.embargoed.fl_str_mv 2021-05-14T15:36:25Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Mitral valve prolapse
Blood pressure
Heart rate
Beta-blockade
datacite.titles.title.fl_str_mv Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
dc.contributor.none.fl_str_mv Repositório Científico de Acesso Aberto da ULisboa
dc.creator.none.fl_str_mv da Silva, Emilia Pereira
Mendes Pedro, Mónica
Varela, Manuel Gato
Cortez-Dias, Nuno
Bicho, Manuel
Madeira, Hugo
Lopes, Mario G.
dc.date.Accepted.fl_str_mv 2007-07-01T00:00:00Z
dc.date.available.fl_str_mv 2021-05-14T15:36:25Z
dc.date.embargoed.fl_str_mv 2021-05-14T15:36:25Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://hdl.handle.net/10451/47899
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv AVES Yayıncılık
dc.rights.cclincense.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv Mitral valve prolapse
Blood pressure
Heart rate
Beta-blockade
dc.title.fl_str_mv Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Objective: There is a well known association between mitral valve prolapse (MVP) and low blood pressure (BP), although patients often have high levels of catecholamines and high heart rate (HR). The main objective of our study was to evaluate the effects of long-term adrenergic beta-blockade on these parameters. Methods: The study population consisted of 46 patients with MVP and the control group consisted of 20 normal individuals. The study had two phases: in the first phase, patients were free of medications. In the second phase, patients were under treatment with propranolol for 10 to 12 months. The tests were performed in normal individuals and patients in the first phase. Only patients underwent the same tests in the second phase. Measurement of urinary epinephrine and norepinephrine levels, by high performance liquid chromatography, was done. Rest HR was determined by electrocardiogram (ECG), and ambulatory blood pressure and HR were evaluated by 24 hours ambulatory blood pressure monitoring (ABPM) using the auscultatory method. Results: The levels of epinephrine and norepinephrine were significantly higher in patients than in normal controls and decreased under propranolol. Rest and ambulatory HR were higher in patients and decreased under propranolol. The 24 hours systolic and diastolic BPs were lower in patients, and their values increased under propranolol. Heart rate decreasing and epinephrine levels reduction were positively correlated. No correlation was found between BP increase and catecholamine levels. Conclusion: The study results show divergent effects of propranolol on blood pressure, which increased, and on heart rate, that decreased, in patients with MVP. Heart rate decrease was an expected result and depends, namely, on b1 receptors blockade. Increase in BP is an unusual response to adrenergic beta-blockade in normal conditions, and this finding supports the preponderance of b2 receptors on the BP control in patients with MVP.
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eu_rights_str_mv openAccess
format article
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identifier.url.fl_str_mv http://hdl.handle.net/10451/47899
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institution Universidade de Lisboa
instname_str Universidade de Lisboa
language eng
network_acronym_str ul
network_name_str Repositório da Universidade de Lisboa
oai_identifier_str oai:repositorio.ulisboa.pt:10451/47899
organization_str_mv urn:organizationAcronym:ul
person_str_mv da Silva, Emilia Pereira
Mendes Pedro, Mónica
Mendes Pedro, Mónica
https://www.ciencia-id.pt/581D-B84F-DE80
581D-B84F-DE80
http://orcid.org/0000-0002-2782-4398
0000-0002-2782-4398
Varela, Manuel Gato
Cortez-Dias, Nuno
Cortez-Dias, Nuno
https://www.ciencia-id.pt/D612-D3C3-6E1D
D612-D3C3-6E1D
http://orcid.org/0000-0002-9244-4631
0000-0002-9244-4631
Bicho, Manuel
Bicho, Manuel
https://www.ciencia-id.pt/9512-8D22-1B28
9512-8D22-1B28
http://orcid.org/0000-0002-5773-5687
0000-0002-5773-5687
Madeira, Hugo
Madeira, Hugo
https://www.ciencia-id.pt/AC1C-BBD0-2EDF
AC1C-BBD0-2EDF
http://orcid.org/0000-0003-4291-2289
0000-0003-4291-2289
Lopes, Mario G.
Lopes, Mario G.
http://orcid.org/0000-0002-2855-5118
0000-0002-2855-5118
publishDate 2007
publisher.none.fl_str_mv AVES Yayıncılık
reponame_str Repositório da Universidade de Lisboa
repository_id_str urn:repositoryAcronym:ul
service_str_mv urn:repositoryAcronym:ul
spelling engAVES Yayıncılıkpt_PTObjective: There is a well known association between mitral valve prolapse (MVP) and low blood pressure (BP), although patients often have high levels of catecholamines and high heart rate (HR). The main objective of our study was to evaluate the effects of long-term adrenergic beta-blockade on these parameters. Methods: The study population consisted of 46 patients with MVP and the control group consisted of 20 normal individuals. The study had two phases: in the first phase, patients were free of medications. In the second phase, patients were under treatment with propranolol for 10 to 12 months. The tests were performed in normal individuals and patients in the first phase. Only patients underwent the same tests in the second phase. Measurement of urinary epinephrine and norepinephrine levels, by high performance liquid chromatography, was done. Rest HR was determined by electrocardiogram (ECG), and ambulatory blood pressure and HR were evaluated by 24 hours ambulatory blood pressure monitoring (ABPM) using the auscultatory method. Results: The levels of epinephrine and norepinephrine were significantly higher in patients than in normal controls and decreased under propranolol. Rest and ambulatory HR were higher in patients and decreased under propranolol. The 24 hours systolic and diastolic BPs were lower in patients, and their values increased under propranolol. Heart rate decreasing and epinephrine levels reduction were positively correlated. No correlation was found between BP increase and catecholamine levels. Conclusion: The study results show divergent effects of propranolol on blood pressure, which increased, and on heart rate, that decreased, in patients with MVP. Heart rate decrease was an expected result and depends, namely, on b1 receptors blockade. Increase in BP is an unusual response to adrenergic beta-blockade in normal conditions, and this finding supports the preponderance of b2 receptors on the BP control in patients with MVP.application/pdfpt_PTHeart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholaminesda Silva, Emilia PereiraPersonalMendes Pedro, MónicaDSpacehttp://dspace.org/items/6b00637f-d663-4f64-8416-bc022a1e1b7fDSpacehttp://dspace.org/items/6b00637f-d663-4f64-8416-bc022a1e1b7fMendes PedroMónicaCiência IDhttps://www.ciencia-id.pt581D-B84F-DE80ORCIDhttp://orcid.org0000-0002-2782-4398Varela, Manuel GatoPersonalCortez-Dias, NunoDSpacehttp://dspace.org/items/36f4a32d-38e4-4c28-9140-4ba468059a22DSpacehttp://dspace.org/items/36f4a32d-38e4-4c28-9140-4ba468059a22Cortez-DiasNunoCiência IDhttps://www.ciencia-id.ptD612-D3C3-6E1DORCIDhttp://orcid.org0000-0002-9244-4631PersonalBicho, ManuelDSpacehttp://dspace.org/items/c61e4f7e-28b3-47b4-bc5d-677b73fc3aecDSpacehttp://dspace.org/items/c61e4f7e-28b3-47b4-bc5d-677b73fc3aecBichoManuelCiência IDhttps://www.ciencia-id.pt9512-8D22-1B28ORCIDhttp://orcid.org0000-0002-5773-5687Scopus Author IDhttps://www.scopus.com7004153755PersonalMadeira, HugoDSpacehttp://dspace.org/items/e108d0e0-df11-4a5e-92e5-40f0138d1249DSpacehttp://dspace.org/items/e108d0e0-df11-4a5e-92e5-40f0138d1249MadeiraHugoCiência IDhttps://www.ciencia-id.ptAC1C-BBD0-2EDFORCIDhttp://orcid.org0000-0003-4291-2289Scopus Author IDhttps://www.scopus.com7004929005PersonalLopes, Mario G.DSpacehttp://dspace.org/items/e10fab1d-b38c-4b29-aed8-68998f1c6d61DSpacehttp://dspace.org/items/e10fab1d-b38c-4b29-aed8-68998f1c6d61LopesMario G.ORCIDhttp://orcid.org0000-0002-2855-5118Scopus Author IDhttps://www.scopus.com7202369014HostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptISSNIsPartOf2149-22632021-05-14T15:36:25Z2007-072007-07-01T00:00:00ZHandlehttp://hdl.handle.net/10451/47899http://purl.org/coar/access_right/c_abf2open accessMitral valve prolapseBlood pressureHeart rateBeta-blockade72928 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal article2007-07http://creativecommons.org/licenses/by-nc/4.0/http://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/9cc44c47-723c-4377-b0d5-b23b91ac5113/downloadThe Anatolian Journal of Cardiology7Suppl 1107109
spellingShingle Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
da Silva, Emilia Pereira
Mitral valve prolapse
Blood pressure
Heart rate
Beta-blockade
status SINGLETON
subject.fl_str_mv Mitral valve prolapse
Blood pressure
Heart rate
Beta-blockade
title Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
title_full Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
title_fullStr Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
title_full_unstemmed Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
title_short Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
title_sort Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines
topic Mitral valve prolapse
Blood pressure
Heart rate
Beta-blockade
topic_facet Mitral valve prolapse
Blood pressure
Heart rate
Beta-blockade
url http://hdl.handle.net/10451/47899
visible 1