Metoprolol abolishes exercise-induced left ventricular dysfunction in patients with silent ischemia

Jan Bech, Jan Kyst Madsen, Henning Kelbaek, Keld Hvid-Jacobsen, Knud Skagen

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    Abstrakt

    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 antiischemic effect of β-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 cardioselective β-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.

    OriginalsprogEngelsk
    Sider (fra-til)871-875
    Antal sider5
    TidsskriftAmerican Journal of Cardiology
    Vol/bind78
    Udgave nummer8
    DOI
    StatusUdgivet - 1 jan. 1996

    Fingeraftryk Udforsk hvilke forskningsemner 'Metoprolol abolishes exercise-induced left ventricular dysfunction in patients with silent ischemia' indeholder.

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