Nasoufidou Athina, Bantidos Marios G, Stachteas Panagiotis, Moysidis Dimitrios V, Mitsis Andreas, Fyntanidou Barbara, Kouskouras Konstantinos, Karagiannidis Efstratios, Karamitsos Theodoros, Kassimis George, Fragakis Nikolaos
Second Cardiology Department, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
J Clin Med. 2025 Jul 23;14(15):5216. doi: 10.3390/jcm14155216.
Coronary artery disease (CAD) constitutes a major contributor to morbidity, mortality and healthcare burden worldwide. Recent innovations in imaging modalities, pharmaceuticals and interventional techniques have revolutionized diagnostic and treatment options, necessitating the reevaluation of established drug protocols or the consideration of newer alternatives. The utilization of beta blockers (BBs) in the setting of acute myocardial infarction (AMI), shifting from the pre-reperfusion to the thrombolytic and finally the primary percutaneous coronary intervention (pPCI) era, has become increasingly more selective and contentious. Nonetheless, the extent of myocardial necrosis remains a key predictor of outcomes in this patient population, with large trials establishing the beneficial use of beta blockers. Computed tomography coronary angiography (CTCA) has emerged as a highly effective diagnostic tool for delineating the coronary anatomy and atheromatous plaque characteristics, with the added capability of MESH-3D model generation. Induction and preservation of a low heart rate (HR), regardless of the underlying sequence, is of critical importance for high-quality results. Landiolol is an intravenous beta blocker with an ultra-short duration of action (t1/2 = 4 min) and remarkable β1-receptor specificity (β1/β2 = 255) and pharmacokinetics that support its potential for systematic integration into clinical practice. It has been increasingly recognized for its importance in both acute (primarily studied in STEMI and, to a lesser extent, NSTEMI pPCI) and chronic (mainly studied in elective PCI) CAD settings. Given the limited literature focusing specifically on landiolol, the aim of this narrative review is to examine its pharmacological properties and evaluate its current and future role in enhancing both diagnostic imaging quality and therapeutic outcomes in patients with CAD.
冠状动脉疾病（CAD）是全球发病、死亡及医疗负担的主要原因之一。近年来，成像技术、药物及介入技术的创新彻底改变了诊断和治疗选择，因此有必要重新评估既定的药物方案或考虑采用更新的替代方案。在急性心肌梗死（AMI）中，β受体阻滞剂（BBs）的应用已从再灌注前时代转变为溶栓时代，最终进入直接经皮冠状动脉介入治疗（pPCI）时代，其使用变得越来越具有选择性且存在争议。尽管如此，心肌坏死的程度仍然是该患者群体预后的关键预测指标，大型试验证实了β受体阻滞剂的有益作用。计算机断层扫描冠状动脉造影（CTCA）已成为一种高效的诊断工具，可用于描绘冠状动脉解剖结构和动脉粥样斑块特征，还具备生成MESH-3D模型的能力。无论采用何种基础序列，诱导并维持低心率（HR）对于获得高质量结果至关重要。兰地洛尔是一种静脉用β受体阻滞剂，作用持续时间超短（t1/2 = 4分钟），具有显著的β1受体特异性（β1/β2 = 255）和药代动力学特性，支持其系统整合到临床实践中的潜力。它在急性（主要在ST段抬高型心肌梗死中进行研究，在非ST段抬高型心肌梗死pPCI中的研究较少）和慢性（主要在选择性PCI中进行研究）CAD环境中的重要性日益得到认可。鉴于专门针对兰地洛尔的文献有限，本叙述性综述的目的是研究其药理特性，并评估其在提高CAD患者诊断成像质量和治疗效果方面的当前及未来作用。
