[Influence of betablocking agents with and without intrinsic sympathicomimetic activity (ISA) on local wall-motion disorders in patients with coronary heart disease].

UNLABELLED

A single blind randomized study on the effect of betablockers with (Pindolol = P, 0.4 mg i.v., n = 10) and without (Metoprolol = M, 5 mg i.v., n = 11) intrinsic sympathicomimetic activity (ISA) on local wall-motion abnormalities was performed in 21 patients with coronary heart disease in anterior wall hypokinesia. Before and 10 minutes after intravenous application of P or M strokes, volume index, cardiac index, heart rate, systolic and enddiastolic left-ventricular pressure were measured. The left-ventricular volumes were calculated biplane with the area-length method of Dodge and Sandler. Analysis of wall-motion disorders were performed by hemichord method measuring 7 hemiaxis and 1 long axis.

RESULTS

Similar hemodynamic effects of both beta-blockers were found on LVEDP und LV-EDVI. Different effects were observed on heart rate and ejection fraction. With M heart rate and ejection fraction decreased, with P heart rate and ejection fraction increased significantly due to the intrinsic sympathicomimetic activity (ISA). Shortening of hypokinetic wall segments was improved by both P and M, shortening of non-hypokinetic contralateral segments, however, remained unchanged with P and decreased with M. With P shortening of chords was improved, whereas with M shortening of chords decreased. Our findings suggest that in therapy of patients with coronary heart disease differential use of beta-blocking agents with or without ISA has to be discussed.