title: The alpha1-adrenergic blocker urapidil improves contractile function in patients 3 months after coronary stenting: a randomized, double-blinded study.
abstract: BACKGROUND
  The recovery of left ventricular function (LVF) after revascularization takes time. alpha-Adrenergic blockade acutely improves coronary blood flow and LVF, whereas the effects of more prolonged alpha-adrenergic blockade on LVF recovery after stenting are unknown.
  
  
  METHODS
  In 32 patients (age 58 +/- 12 y) with an 82% +/- 6% stenosis, ejection fraction (EF) and systolic thickening (%Th) were measured by transthoracic echocardiography before and 30 minutes to 2 hours after revascularization. In a double-blinded protocol, either 200 microg/kg urapidil or placebo was given intravenously, and LVF was measured 10 minutes later. Two hours later, oral treatment with 30 mg/d drug or placebo was started, and LVF measured again after 24 hours and 3 months.
  
  
  RESULTS
  Before revascularization, EF was 49.4% +/- 8.5% (+/-SD) and 51.3% +/- 8.8% in the urapidil-treated and the placebo groups, respectively. Thirty minutes to 2 hours after coronary stenting, EF was unchanged. After intravenous drug administration, EF increased to 56.5% +/- 9.7%). At 24 hours and 3 months after revascularization, EF became 59.5% +/- 7.9% and 59.6% +/- 8.2% in the urapidil-treated group, respectively, whereas EF in the placebo group did not change (50.4% +/- 5.7% and 49.7% +/- 4.9%, respectively). Revascularization did not acutely improve %Th. Intravenous urapidil improved %Th from 31.4% +/- 17.6% to 44.2% +/- 11.6%, whereas there was no change in the placebo group. At 3 months, %Th was 49.5% +/- 12.9% in the urapidil-treated group and 39.7% +/- 8.9% in the placebo group.
  
  
  CONCLUSIONS
  These data suggest that long-term alpha-adrenergic blockade might improve LVF at midterm after coronary revascularization.
authors.affiliation: Clinique Pasteur, Centre de Cardiologie Interventionelle, Toulouse, France.
authors.forename: Michaela
authors.initials: M
authors.lastname: Kozàkovà
authors.forename: Jean
authors.initials: J
authors.lastname: Marco
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
authors.forename: Monique
authors.initials: M
authors.lastname: Bernies
authors.forename: Irene M
authors.initials: IM
authors.lastname: Bossi
authors.forename: Carlo
authors.initials: C
authors.lastname: Palombo
authors.forename: Gian Battista
authors.initials: GB
authors.lastname: Anguissola
authors.forename: Francesco
authors.initials: F
authors.lastname: Donatelli
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Laurent
authors.forename: Luisa
authors.initials: L
authors.lastname: Gregorini
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use*; D015607:Stents; D013318:Stroke Volume / Q000187:drug effects*; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy
chemical_list: D000317:Adrenergic alpha-Antagonists; D010879:Piperazines; C015568:urapidil