Metoprolol Abolishes Exercise-Induced Left Ventricular Dysfunction in Patients With Silent Ischemia**This study was supported by grants from the Danish Heart Foundation, and the Laurits Peter Christensen and Kirsten Sigrid Christensen Foundation
| Autor: | Keld Hvid-Jacobsen, Jan Bech, Knud Skagen, Jan Kyst Madsen, Henning Kelbæk |
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| Rok vydání: | 1996 |
| Předmět: |
medicine.medical_specialty
Ejection fraction medicine.diagnostic_test business.industry Ischemia medicine.disease Placebo Asymptomatic Coronary artery disease Internal medicine Anesthesia cardiovascular system medicine Cardiology cardiovascular diseases medicine.symptom Exercise physiology Cardiology and Cardiovascular Medicine business Electrocardiography circulatory and respiratory physiology Metoprolol medicine.drug |
| Zdroj: | The American Journal of Cardiology. 78:871-875 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/s0002-9149(96)00459-6 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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