Abstract
To evaluate the chronic effects of theophylline on cardiac function, M-mode and pulsed Doppler derived variables were measured at rest and the suprasternal continuous wave Doppler measurement of ascending aortic flow was used during treadmill exercise testing. Subjects consisted of 13 children with stable asthma (mean 11.7±2.2 years) who were treated with theophylline for at least one year and 16 age-matched, untreated normal volunteers. In the resting state, the chronic administration of theophylline seemed to produce a slight increase in percent fractional shortening, outflow peak velocity and atrial contribution to ventricular filling in the asthmatic children as compared to normals, but these changes were not statistically significant. The asthmatic children showed significantly lower values than the controls in exercise induced changes in the peak velocity, stroke index and cardiac index, but not in the heart rate. Therefore, chronic administration of theophylline appears to have a minimal effect on resting cardiac function, but a possibly deleterious effect on the cardiac response to exercise testing.
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References
Menendez R, Kelly HW. Theophylline therapy. J Asthma 1983; 20: 455–466
Rall TW, West TC. The potentiation of cardiac inotropic responses to norepinephrine. J Pharmacol Exp Ther 1963; 139: 269–274
Ellis EF. Theophylline toxicity. J Allergy Clin Immunol 1985; 76: 297–301
American Thoracic Society. Definition and classification of bronchitis, asthma, and pulmonary emphysema. Am Rev Respir Dis 1962; 85: 762–769
Feigenbaum H. Echocardiography.Echocardiographic evaluation of cardiac chambers. Philadelphia: Lea & Febiger, 1986: 127
Feigenbaum H. Echocardiography.Hemodynamic information derived from echocardiography. Philadelphia: Lea & Febiger, 1986: 191
Maeda M, Yokota M, Iwase M, Miyahara M, Hayashi H, Sotobata I. Accuracy of cardiac output measured by continuous wave Doppler echocardiography during dynamic exercise testing in the supine position in patients with coronary artery disease. J Am Coll Cardiol 1989; 13: 76–83
Iwase M, Maeda M, Noda S, et al. Continuous wave Doppler echocardiographic evaluation of cardiac output and its application to treadmill exercise. Am J Noninvas Cardiol 1990; 4: 159–166
Sotobata I, Shino T, Kondo T, et al. Work intensities of different mode of exercise testings in clinical use. Jap Circ J 1979; 43: 161–166
Herman G, Aynesworth MB, Martin J. Successful treatment of persistent dyspnea ‘status asthmatics’. J Lab Clin Med 1937; 23: 135–145
Schack JA, Waxler SH. An ultraviolet spectophotometric method for the determination of theophylline and theibromine in blood and tissues. J Pharmacol Exp Ther 1949; 97: 283–291
Bastianon V, Fazio AD, Colloridi V, et al. Lack of adverse cardiac effects of combined treatment with theophylline and albuterol in asthmatic children. Ann Allergy 1990; 65: 201–205
Ebbesen P. Myocardial degeneration in mice treated with dibutyryl cyclic AMP and/or theophylline. Virchows Arc Pathol Anat Histol 1976; 372: 89–97
Packer M, Medina N, Yushak M. Hemodynamic and clinical limitations of long-term inotropic therapy with amrinone in patients with severe chronic heart failure. Circulation 1984; 70: 1038–1047
Appleton CP, Hatle LK, Popp RL. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol 1988; 12: 426–440
Cohn JH, Levine TB, Olivari MT, et al. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 1984; 311: 819–823
Higbee MD, Kumar M, Galant SP. Stimulation of endogenous catecholamine release by theophylline: a proposed additional mechanism of action for theophylline effects. J Allergy Clin Immunol 1982; 70: 377–382
Lock JE, Eizig S, Moller JH. Hemodynamic responses to exercise in normal children. Am J Cardiol 1978; 41: 1278–1284
Gewilling MH, Lundstrom UR, Bull C, Wyse RKH, Deanfield JE. Exercise responses in patients with congenital heart disease after Fontan repair: patterns and determinations of performance. J Am Coll Cardiol 1990; 15: 1424–32
Sugishita Y, Koseki S, Matsuda M, Yamaguchi T, Ito I. Influence of ergometer exercise on aortic pressure-diameter relationship in healthy men. Jpn Heart J 1982; 23: 315–27
Loeber CP, Goldberg SJ, Marx GR, Carrier M, Emery RW. How much does aortic and pulmonary artery area vary during the cardiac cycle? Am Heart J 1987; 113: 95–1,00
Cooper DM, Cutz E, Levison H. Occult pulmonary abnormalities in asymptomatic asthmatic children. Chest 1977; 71: 361–365
Brodde OE, Michel-Reher M, Boomsma F, Manin't Veld AJ, Schieper P, Michel MC. Agonist desensitization of beta-adrenoceptor function in humans. Circulation 1990; 81: 914–921
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Aoki, T., Iwase, M., Watanabe, T. et al. Left ventricular function in asthmatic children chronically treated with theophylline evaluated by exercise Doppler echocardiography. Int J Cardiac Imag 10, 299–304 (1994). https://doi.org/10.1007/BF01137721
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DOI: https://doi.org/10.1007/BF01137721