title: Changes in components of left ventricular mechanics under selective beta-1 blockade: insight from traditional and new technologies in echocardiography.
abstract: OBJECTIVE
  Myocardial inotropism is considered to be reduced under beta-1 adrenoreceptor blockage (beta1-block). However, relationships between components of left ventricular (LV) systolic mechanics under beta1-block accounting for physiological correlates are only partially explored.
  
  
  RESULTS
  Hypertensive outpatient without previous cardiovascular events and with normal LV ejection fraction (EF) at rest underwent echocardiographic evaluations of LV size and systolic function by standard, tissue-Doppler, and speckle-tracking methods before and after 2 weeks of treatment with bisoprolol to obtain change in LV systolic mechanics at a stable heart rate reduction (-20 +/- 10% from baseline) without significant change in LV mass. In the study sample (n = 26, 62% women, mean age 52 +/- 10 years), under bisoprolol, afterload [i.e. circumferential (CESS) and meridional (MESS) end-systolic stress], LV mass, left atrial volume, and EF did not change significantly; LV chamber contractility [i.e. CESS/LV end-systolic volume index (CESS/ESVi) as well as MESS/ESVi] and relative wall thickness (RWT) decreased; stroke volume increased (all P < 0.05). Circumferential LV contractility (i.e. stress-corrected midwall shortening) increased, whereas regional longitudinal strain and strain rate, and global longitudinal strain decreased (all P < 0.05). Peak velocities of the systolic displacement of the lateral and medial mitral anulus did not change under bisoprolol. Parameters of longitudinal LV systolic function did not correlate with preload, afterload, RWT, or with stoke volume.
  
  
  CONCLUSIONS
  In hypertensive subjects with preserved LV EF, parameters of longitudinal LV systolic mechanics may not reflect the LV myocardial contractility status in steady-state conditions under short-term treatment with beta1-block.
authors.affiliation: Unit of Cardiology, Ospedale dei Pellegrini ASL Napoli 1, Naples 80134, Italy. vpalmier@med.cornell.edu
authors.forename: Vittorio
authors.initials: V
authors.lastname: Palmieri
authors.forename: Cesare
authors.initials: C
authors.lastname: Russo
authors.forename: Emiliano A
authors.initials: EA
authors.lastname: Palmieri
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pezzullo
authors.forename: Aldo
authors.initials: A
authors.lastname: Celentano
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D004452:Echocardiography / Q000379:methods* / Q000639:trends; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*
chemical_list: D000319:Adrenergic beta-Antagonists