Administration of nebivolol after coronary artery bypass in patients with altered left ventricular function.
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.
Goldstein
M
M
Erasme University Hospital, Free University of Brussels, Belgium.
Vincent
J L
JL
De Smet
J M
JM
Barvais
L
L
Van Nueten
L
L
Scheijgrond
H
H
d'Hollander
A
A
Leclerc
J L
JL
Kahn
R J
RJ
D058671:Adrenergic beta-1 Receptor Antagonists; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D001262:Atenolol / Q000009:adverse effects / Q000627:therapeutic use; D016279:Atrial Function, Left / Q000187:drug effects*; D001578:Benzopyrans / Q000009:adverse effects / Q000627:therapeutic use*; D001810:Blood Volume / Q000187:drug effects / Q000502:physiology; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004311:Double-Blind Method; D015150:Echocardiography, Doppler; D004983:Ethanolamines / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects; D013617:Tachycardia, Supraventricular / Q000517:prevention & control; D014160:Transducers, Pressure; D014655:Vascular Resistance / Q000187:drug effects
D058671:Adrenergic beta-1 Receptor Antagonists; D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol; D001262:Atenolol