[Influence of betablocking agents with and without intrinsic sympathicomimetic activity (ISA) on local wall-motion disorders in patients with coronary heart disease].
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.
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D003327:Coronary Disease / Q000188:drug therapy*; D005260:Female; D006321:Heart / Q000187:drug effects*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D010869:Pindolol / Q000494:pharmacology / Q000627:therapeutic use; D011897:Random Allocation
D000319:Adrenergic beta-Antagonists; D010869:Pindolol; D008790:Metoprolol
Einfluss von Beta-Rezeptorenblockern mit und ohne Intrinsic-Aktivität auf lokale Wandbewegungsstörungen bei Patienten mit koronarer Herzkrankheit.