Document Detail


Comparative effects of propranolol and verapamil alone and in combination on left ventricular function and volumes in patients with chronic exertional angina: a double-blind, placebo-controlled, randomized, crossover study with radionuclide ventriculography.
MedLine Citation:
PMID:  6315259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
With the use of equilibrium radionuclide ventriculography the effects on left ventricular (LV) function of 160 mg oral propranolol daily and 360 mg verapamil daily alone and in combination were compared in 18 patients with chronic exertional angina. A randomized, double-blind, placebo-controlled, crossover protocol was used. The reduction in exercise rate-pressure product induced by the combination (118 +/- 28 mm Hg/min) was significantly greater (p less than .05) than that by propranolol (135 +/- 27 mm Hg/min) or verapamil alone (163 +/- 28 mm Hg/min). In patients at rest, neither single nor combined therapy altered global or regional left ventricular ejection fractions (EFs). Verapamil, but not propranolol, increased (p less than .05) cardiac volumes of resting subjects; used in combination, no further increase in LV volume occurred. With placebo, exercise global EF did not decrease from the level at rest and therefore no drug effect could be demonstrated for this parameter of LV function. By an evaluation of normalized regional EF measurements the combination was shown to reduce exercise-induced hypokinesis (placebo 52 +/- 20%, combination 61 +/- 23%; p less than .01). No significant improvement was noted with propranolol or verapamil alone; only the combination prevented a significant increase in end-systolic and end-diastolic volumes during exercise. Thus, propranolol and verapamil, used alone in moderate doses, exert no beneficial effect on exercise LV function as measured by EF and volume changes, and resting function deteriorates slightly with verapamil.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D L Johnston; V A Gebhardt; A Donald; W J Kostuk
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  68     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1983 Dec 
Date Detail:
Created Date:  1984-01-27     Completed Date:  1984-01-27     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1280-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / drug therapy*,  radionuclide imaging
Blood Pressure / drug effects
Double-Blind Method
Drug Therapy, Combination
Electrocardiography
Female
Heart Rate / drug effects
Humans
Male
Middle Aged
Myocardial Contraction / drug effects
Physical Exertion
Propranolol / administration & dosage,  therapeutic use*
Random Allocation
Sodium Pertechnetate Tc 99m
Stroke Volume / drug effects
Technetium / diagnostic use
Verapamil / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
23288-60-0/Sodium Pertechnetate Tc 99m; 52-53-9/Verapamil; 525-66-6/Propranolol; 7440-26-8/Technetium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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