| Metoprolol abolishes exercise-induced left ventricular dysfunction in patients with silent ischemia. | |
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MedLine Citation:
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PMID: 8888657 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Left ventricular systolic function is reduced during episodes of silent ischemia in patients with coronary artery disease (CAD). Left ventricular ejection fraction (LVEF) is increased at least 5 absolute percent during exercise in most normal subjects; however, in patients with CAD, LVEF often remains unchanged or decreases. The anti-ischemic effect of beta-adrenergic receptor blockade is well documented, including a reduction of exercise-induced electrocardiographic ST depressions; however, the effect of these drugs on left ventricular volume changes during exercise in patients with silent ischemia is unknown. The aim of this study was to evaluate the effect of a cardio-selective beta-blocking agent, metoprolol, on rest and exercise LVEF in patients with silent ischemia, using radionuclide cardiography. Fifteen patients with silent ischemia completed a double-blind, placebo-controlled crossover study at rest and during submaximal exercise. LVEF remained unchanged during exercise in the placebo phase (56% to 58%; p = NS), but even though LVEF tended to decrease 56% during rest after metoprolol versus 52% after placebo (p = NS), the LVEF increase from rest to exercise resembled a normal LVEF response, 52% to 58% (p = 0.005). Exercise-induced electrocardiographic ST depressions were also reduced during metoprolol treatment. In patients with silent ischemia, the exercise-induced change in LVEF rises significantly during metoprolol treatment. The mechanism may be a reduction in myocardial ischemia as indicated by a reduction in ischemic electrocardiographic findings. |
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Authors:
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J Bech; J K Madsen; H Kelbaek; K Hvid-Jacobsen; K Skagen |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 78 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1996 Oct |
Date Detail:
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Created Date: 1996-12-04 Completed Date: 1996-12-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 871-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Clinical Physiology/Nuclear Medicine, Copenhagen University Hospital, Herlev, Denmark. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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pharmacology* Cross-Over Studies Double-Blind Method Electrocardiography Exercise / physiology* Exercise Test Female Gated Blood-Pool Imaging Humans Male Metoprolol / pharmacology* Middle Aged Myocardial Ischemia / diagnosis, physiopathology* Stroke Volume / drug effects Technetium Tc 99m Sestamibi / diagnostic use Ventricular Dysfunction, Left / diagnosis, physiopathology, prevention & control* Ventricular Function, Left / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 109581-73-9/Technetium Tc 99m Sestamibi; 37350-58-6/Metoprolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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