© 2000 European Society of Cardiology
Celiprolol augments the effect of physical exercise on insulin sensitivity and serum lipid levels in chronic heart failure
a Department of Medicine, Turku University Central Hospital Kiinamyllynk 4-8, 20520 Turku, Finland
b Departments of Internal Medicine and Clinical Pharmacology, Tampere University Hospital Turku, Finland
c Department of Pharmacology and Clinical Pharmacology, University of Turku Turku, Finland
d Department of Clinical Chemistry, Turku University Central Hospital Kiinamyllynk 4-8, 20520 Turku, Finland
e The Social Insurance Institution, Research and Development Centre Turku, Finland
* Corresponding author. Tel.: +358-2-2611-611; fax: +358-2-2612-030.
 |
Abstract |
|---|
Purpose: Impaired insulin sensitivity has been linked with chronic heart failure (CHF). Exercise has a beneficial effect on insulin sensitivity in healthy subjects. It is used also as an adjunctive therapy in patients with CHF. We studied the effect of randomized treatment with celiprolol, a vasodilating β1-adrenoceptor antagonist, 200 mg once daily (n=20) or placebo (n=11) on serum lipid levels and insulin sensitivity in patients with CHF. In addition, all subjects participated in a 6-month exercise training protocol. Thirteen subjects in the celiprolol and eight subjects in the control group were on additional β1-adrenoceptor antagonist as part of their tailored CHF therapy. Insulin sensitivity was determined using the hyperinsulinemic euglycemic clamp test (diabetic subjects excluded, n=11 for the celiprolol group and n=8 for the placebo group).
Results: Insulin sensitivity index (ISI) increased by 33% (P<0.05) in the celiprolol group and by 17% (NS) in the control group. The mean increase in the whole group was 20% [from 68.2±11.5 to 81.7±10.7 ml/min/kg (mU/l), P<0.05]. No change was found in the total cholesterol level. HDL cholesterol levels increased by 12% (from 0.98±0.05 to 1.10±0.05 mmol/l, P<0.005), and HDL/total cholesterol and HDL/LDL cholesterol ratios by 15% and 16%, respectively (P<0.005). The increase in serum fasting HDL cholesterol level was greater in the celiprolol-treated group (P<0.05). At baseline ISI correlated with maximal oxygen uptake (r=0.65, P<0.0001) and body mass index (r=–0.55, P<0.001). The change in ISI correlated weakly with the improvement in muscle exercise capacity (r=0.53, P<0.05).
Conclusions: Insulin sensitivity and serum lipid levels may be favorably affected by exercise training in subjects with mild-to-moderate CHF. Celiprolol, a vasodilating β1- selective adrenoceptor antagonist, potentiates this effect.
Key Words: Insulin sensitivity • Heart failure • Exercise training • Celiprolol • Clinical trial • Euglycaemic clamp
Received June 28, 1999; Revised December 7, 1999; Accepted December 20, 1999
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M A Spruit, R-M A Eterman, V A C V Hellwig, P P Janssen, E F M Wouters, and N H M K Uszko-Lencer Effects of moderate-to-high intensity resistance training in patients with chronic heart failure Heart, September 1, 2009; 95(17): 1399 - 1408. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L.W.E. Sabelis, P.J. Senden, M.L. Zonderland, A. van de Wiel, J.P.M. Wielders, I.A. Huisveld, T.W. van Haeften, and W.L. Mosterd Determinants of insulin sensitivity in chronic heart failure Eur J Heart Fail, December 1, 2003; 5(6): 759 - 765. [Abstract] [Full Text] [PDF]
|
|