Goldstein M, Vincent J L, De Smet J M, Barvais L, Van Nueten L, Scheijgrond H, d'Hollander A, Leclerc J L, Kahn R J
Erasme University Hospital, Free University of Brussels, Belgium.
J Cardiovasc Pharmacol. 1993 Aug;22(2):253-8. doi: 10.1097/00005344-199308000-00013.
This prospective, double-blind study used invasive monitoring and echo-Doppler techniques to compare the hemodynamic effects of nebivolol, a new beta 1-selective beta-blocking agent with those of atenolol in patients recovering from coronary artery bypass grafting surgery. Five milligrams nebivolol and 50 mg atenolol equally decreased heart rate (HR) and blood pressure (BP) but, nebivolol, in contrast to atenolol, caused no decrease in stroke index (SI), cardiac index (CI), and right ventricular ejection fraction (RVEF). These differences appeared to be related in part to different peripheral effects of the two agents because nebivolol administration was associated with a reduction in systemic vascular resistance (SVR). After < or = 10 days of treatment, acceleration of aortic flow velocity increased and isovolumic relaxation time decreased with nebivolol but not with atenolol treatment. Both drugs were equally well tolerated. Therefore, nebivolol shares most of its effects with classical beta 1-blockers but is devoid of the potentially harmful effects on cardiac output (CO) and peripheral resistance.
这项前瞻性双盲研究采用侵入性监测和超声多普勒技术，比较新型β1选择性β受体阻滞剂奈必洛尔与阿替洛尔对冠状动脉搭桥手术后恢复过程中患者的血流动力学影响。5毫克奈必洛尔和50毫克阿替洛尔均能同等程度降低心率（HR）和血压（BP），但与阿替洛尔不同，奈必洛尔不会使每搏指数（SI）、心脏指数（CI）和右心室射血分数（RVEF）降低。这些差异似乎部分与两种药物不同的外周效应有关，因为给予奈必洛尔会使全身血管阻力（SVR）降低。治疗≤10天后，奈必洛尔治疗可使主动脉流速加快、等容舒张时间缩短，而阿替洛尔治疗则无此效果。两种药物的耐受性相当。因此，奈必洛尔与经典β1受体阻滞剂有大部分相同的作用，但对心输出量（CO）和外周阻力无潜在有害影响。
