The subjects in this group will receive the usual care, which includes the non-pharmacology recommendations by the European Society of Cardiologists 2006 (1) and COPD guides for treatment (6), both founded in the sodium and liquids restriction.

Patients in this group will receive pulmonary rehabilitation specified by rehabilitation doctors according to the needs and capacities of each individual, who will attend three times a week for three months.

Patients in this group will receive pulmonary rehabilitation specified by rehabilitation doctors according to the needs and capacities of each individual, who will attend three times a week for three months. Furthermore, they will receive 4g of citrulline supplementation.

Patients in this group will receive pulmonary rehabilitation specified by the doctor specialized in rehabilitation according to the needs and capacities of each individual, who will attend three times a week for three months. Furthermore, they will receive 4g of citrulline supplementation.

Heart Failure

Copd

Nutritional Supplementation

Pulmonary Rehabilitation

Nutritional supplementation (HMB 4g) or Nutritional supplementation (citrulline 3g) with Pulmonary Rehabilitation

Nutritional supplementation and Pulmonary Rehabilitation

Dulce González-Islas

Effect of Nutritional Supplementation and Pulmonary Rehabilitation on the Clinical Status of HF and COPD

Evaluation of the Effect of Nutritional Supplementation and Pulmonary Rehabilitation on the Clinical Status of Patients With Heart Failure and Chronic Obstructive Pulmonary Disease

Change from baseline in functional class assessed by NYHA

Change from baseline in the skeletal muscle mass assessed by bioelectrical impedance

Change from baseline in pulmonary function assessed by spirometry test

Change from baseline in pulmonary function assessed by dinamometry test

Dulce González Islas, PhD

Researcher in Medical Sciences

Instituto Nacional de Enfermedades Respiratorias

Participants first received Nebivolol at a dose of 5 mg daily for 4 weeks, followed by 10 mg daily for another 4 weeks (i.e., weeks 1-8 in total). The participants then received Metoprolol at a dose of 50 mg daily for 4 weeks, followed by 100 mg daily for another 4 weeks (i.e., weeks 9-16 in total).

Participants first received Metoprolol at a dose of 50 mg daily for 4 weeks, followed by 100 mg daily for another 4 weeks (i.e., weeks 1-8 in total). The participants then received Nebivolol at a dose of 5 mg daily for 4 weeks, followed by 10 mg daily for another 4 weeks (i.e., weeks 9-16 in total)

Participants who were randomized to receive either Nebivolol followed by Metoprolol or Metoprolol followed by Nebivolol.

All Study Participants

Sex: Female, Male

Region of Enrollment

A 16 item scale that measures 4 dimensions of fatigue: severity, distress, timing, and degree of interference in activities of daily living.
Range: 1 (no fatigue) to 50 (extreme fatigue).

31 subjects received Nebivolol 5 mg daily for 4 weeks.

Nebivolol 5 mg for 4 Weeks

31 subjects received Metoprolol 50 mg daily for 4 weeks

Metoprolol 50 mg for 4 Weeks

31 subjects received Nebivolol 10 mg daily for 4 weeks.

Nebivolol 10 mg for 4 Weeks

31 subjects received Metoprolol 100 mg daily for 4 weeks

Metoprolol 100 mg for 4 Weeks

Multidimensional Assessment of Fatigue (MAF) Questionnaire: Global Fatigue Score After 4 Weeks of Treatment on Each Drug/Dose Combination.

Treadmill Exercise Time After 4 Weeks of Treatment on Each Drug/Dose Combination (in minutes). The Treadmill Test was Performed at the 4-week Visit of Each Drug/Dose Combination.

succinate/fatigue

Effect of Nutritional Supplementation and Pulmonary Rehabilitation on the Clinical Status of HF and COPD

Nebivolol Versus Metoprolol: Comparative Effects on Fatigue and Quality of Life

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