Document Detail


Metoprolol does not effect myocardial fractional flow reserve in patients with intermediate coronary stenoses.
MedLine Citation:
PMID:  17827819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Myocardial fractional flow reserve (FFR) is utilized to determine the hemodynamic significance of coronary stenoses. We sought to determine the effect, if any, of metoprolol on FFR in patients with coronary stenoses of intermediate severity. METHODS AND RESULTS: Eighteen patients (10 males, mean age, 59.4 +/- 7.7 years) with isolated, intermediate (30% to 70% narrowing on coronary angiogram) lesions on the proximal LAD and a preserved ejection fraction, underwent FFR measurement using a 0.014 inch pressurewire and intracoronary adenosine injection before and after intravenous metoprolol at a dose that achieved at least a 10% decrease in the heart rate. Heart rate dropped significantly with metoprolol. At the premetoprolol measurement, aortic pressure (Pa) remained essentially the same (105.7 +/- 11.5 versus 105.6 +/- 11.6 mmHg, P > 0.05) and distal coronary pressure (Pd) dropped significantly by 9% from 96.3 +/- 12.7 to 87.4 +/- 13.4 mmHg (P < 0.001) after adenosine injection yielding an FFR(1) of 0.83 +/- 0.07. At the postmetoprolol phase, Pa dropped nonsignificantly by 2% from 104.4 +/- 12.8 to 102.4 +/- 14.3 mmHg (P = 0.09) and Pd dropped significantly by 11% from 95.7 +/- 14.4 to 85.3 +/- 16.4 mmHg (P < 0.001) after adenosine injection, yielding an FFR(2) of 0.83 +/- 0.08, which was almost exactly the same as FFR(1) (P > 0.05). CONCLUSION: In this study, FFR was found not to be influenced by metoprolol treatment in patients with intermediate coronary stenoses and a preserved ejection fraction.
Authors:
Murat Ozdemir; Guliz Erdem Yazici; Sedat Turkoglu; Timur Timurkaynak; Atiye Cengel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International heart journal     Volume:  48     ISSN:  1349-2365     ISO Abbreviation:  -     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-09-10     Completed Date:  2008-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  477-83     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Gazi University School of Medicine, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / pharmacology
Adrenergic beta-Antagonists / administration & dosage,  pharmacology*
Blood Pressure / drug effects
Coronary Circulation / drug effects
Coronary Stenosis / physiopathology*
Female
Fractional Flow Reserve, Myocardial / drug effects*
Heart Rate / drug effects
Humans
Male
Metoprolol / administration & dosage,  pharmacology*
Middle Aged
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 37350-58-6/Metoprolol; 58-61-7/Adenosine

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


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