Effects of esmolol on cardiac function: evaluation by noninvasive techniques.

In a double-blind, randomized, crossover study, the effects of esmolol and propranolol were examined at rest and during peak upright exercise in 15 patients. At rest, both esmolol and propranolol significantly decreased heart rate, systolic blood pressure, rate-pressure product, left ventricular ejection fraction, cardiac index and right ventricular ejection fraction. During exercise, significant decreases were also found in heart rate, systolic blood pressure and cardiac index in both treatment groups. No significant differences were found between mean esmolol and mean propranolol measurements at rest and during exercise, except for the exercise systolic blood pressure, which was lower during esmolol infusion. Blood levels of esmolol decreased markedly by 30 minutes postinfusion, as did its beta-blocking action. Esmolol was well tolerated with no important local, systemic or laboratory abnormalities. Thus, the effects of esmolol on cardiovascular performance at rest and during exercise are similar to those of propranolol.