Document Detail


Metoprolol abolishes exercise-induced left ventricular dysfunction in patients with silent ischemia.
MedLine Citation:
PMID:  8888657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J Bech; J K Madsen; H Kelbaek; K Hvid-Jacobsen; K Skagen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-12-04     Completed Date:  1996-12-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  871-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Physiology/Nuclear Medicine, Copenhagen University Hospital, Herlev, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / 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:
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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