[Therapeutic problems in hyperkinetic heart syndrome].

At present beta-blockers are the therapy recommended in hyperkinetic heart syndrome. This therapeutical advice was investigated by two cross over studies: the first trial was a comparison between the circulatory effects of Celiprolol and Pindolol, the second one between Oxprenolol and the calcium antagonist Verapamil. All beta-blockers tested effected a safe reduction in heart rate, which is elevated in hyperkinetic state, but failed to lower diastolic blood pressure by at least 15 mm Hg. Verapamil however, also effected bradycardia but did not reduce heart-rate in the same amount as beta-blockers. Furthermore the calcium antagonist's hypotensive effects are more pronounced by comparison with beta-blockers. According to these findings beta-blockers are not to be seen as therapy of first choice in hyperkinetic heart syndrome, they are only recommended combined with diuretics or vasodilators. As alternative therapy Verapamil could be prescribed, which disadvantage is the necessity of taking it several times per day.