title: Effect of beta-adrenoceptor blockade on atrial natriuretic peptide levels during exercise in angina pectoris.
abstract: The effects of epanolol (200 mg once daily) and diltiazem (60 mg three times daily) on the response of atrial natriuretic peptide (ANP) to exercise were investigated in a double-blind placebo-controlled crossover study in 16 patients with angina pectoris. Exercise tolerance as assessed by peak oxygen consumption was similar with all treatments. Peak heart rate (mean and 95% confidence intervals) was lower (P < 0.05) with epanolol (121 (115-130) beats min-1) than with diltiazem (137 (126-148) beats min-1) or placebo (141 (130-152) beats min-1). ANP did not change from resting values with placebo or diltiazem, but rose significantly (P < 0.05) with epanolol from 19.7 (13.0-29.8) pg ml-1 (geometric mean and 95% confidence intervals) during supine rest to 49.6 (33.7-73.0) pg ml-1 at peak exercise. Since ANP release is stimulated by atrial distension, patients with untreated angina may stop exercise before atrial dilatation occurs. With beta-adrenoceptor blockade, a reduction in peak heart rate may necessitate increased chamber volumes to maintain cardiac output, accounting for the rise in ANP.
authors.affiliation: Royal Victoria Hospital, Belfast, N. Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Riley
authors.forename: J S
authors.initials: JS
authors.lastname: Elborn
authors.forename: G
authors.initials: G
authors.lastname: Onuoha
authors.forename: C
authors.initials: C
authors.lastname: Erwin
authors.forename: C
authors.initials: C
authors.lastname: Shaw
authors.forename: M M
authors.initials: MM
authors.lastname: Khan
authors.forename: C F
authors.initials: CF
authors.lastname: Stanford
authors.forename: D P
authors.initials: DP
authors.lastname: Nicholls
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000503:physiopathology*; D009320:Atrial Natriuretic Factor / Q000097:blood*; D044482:Benzeneacetamides; D002302:Cardiac Output / Q000187:drug effects; D004110:Diltiazem / Q000008:administration & dosage / Q000494:pharmacology; D004311:Double-Blind Method; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D011412:Propanolamines / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D000319:Adrenergic beta-Antagonists; D044482:Benzeneacetamides; D011412:Propanolamines; D009320:Atrial Natriuretic Factor; C038616:epanolol; D004110:Diltiazem