Effect of oral propranolol on rest and exercise left ventricular ejection fraction, volumes, and segmental wall motion in patients with angina pectoris. Assessment with equilibrium gated blood pool imaging.

Dehmer, Gregory J.; Falkoff, Michael D.; Lewis, Samuel E.; Hillis, L.David; Parkey, Robert W.; Willerson, James T.

doi:10.1136/hrt.45.6.656

Cited by 41 publications

(5 citation statements)

References 31 publications

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“…Following nicardipine, would the improvement in cardiac pumping-function in the kinds of patients observed in the present studies, offset the disadvantages to cardiac function that are inherent in,B-adrenoceptor blockade (Nelson et al, 1984)? Would the addition of nicardipine to ,i-adrenoceptor blocker therapy offset the increase in cardiac volume usually observed during fJ-adrenoceptor blocker monotherapy (Dehmer et al, 1981)? In view of the frequent concomitant prescription of fi-adrenoceptor blocking and slow-channel blocking agents, the extent to which nicardipine can be expected to contribute to the maintainance of cardiac function during intercurrent fl-adrenoceptor blockade urgently needs to be examined.…”

Section: Resultsmentioning

confidence: 99%

Effects of nicardipine on cardiac volume at rest and during exercise‐ induced angina.

Silke¹,

Verma²,

Frais³

et al. 1985

Brit J Clinical Pharma

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The action of nicardipine on cardiac volume, both at rest and during exercise‐induced angina, was evaluated in 12 patients with angiographically‐proven coronary artery disease. Nicardipine given to patients at rest reduced systemic vascular resistance and mean arterial pressure and increased heart rate and cardiac index. The left ventricular filling pressure, ejection fraction (EF), end‐diastolic and end‐systolic volumes were unchanged. During supine bicycle exercise, the reduction in systemic arterial blood pressure following nicardipine increased cardiac and stroke index and attenuated the rise in left ventricular filling pressure observed in the control exercise. The effects of nicardipine on EF, end‐diastolic and end‐systolic cardiac volumes were dependent on the baseline cardiac reserve. In patients with EF less than 50%, nicardipine improved EF and left ventricular exercise volumes.

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Section: Resultsmentioning

confidence: 99%

Effects of nicardipine on cardiac volume at rest and during exercise‐ induced angina.

Silke¹,

Verma²,

Frais³

et al. 1985

Brit J Clinical Pharma

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“…Heart rate, blood pressure, and electrocardiographic changes ( 30 Observation of changes in cardiac volumes, particularly end-systolic volume and the PSP/ESVI ratio. In this study, a significant improvement in exercise-induced hypokinesis occurred only with the combination therapy and this beneficial effect was associated with a significant reduction in ratepressure product compared with after propranolol alone.…”

Section: Methodsmentioning

confidence: 99%

Comparative effects of propranolol and verapamil alone and in combination on left ventricular function and volumes in patients with chronic exertional angina: a double-blind, placebo-controlled, randomized, crossover study with radionuclide ventriculography.

Johnston¹,

Gebhardt²,

Donald³

et al. 1983

Circulation

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With the use of equilibrium radionuclide ventriculography the effects on left ventricular (LV) function of 160 mg oral propranolol daily and 360 mg verapamil daily alone and in combination were compared in 18 patients with chronic exertional angina. A randomized, double-blind, placebocontrolled, crossover protocol was used. The reduction in exercise rate-pressure product induced by the combination (1 18 ± 28 mm Hg/min) was significantly greater (p < .05) than that by propranolol (135 + 27 mm Hg/min) or verapamil alone (163 ± 28 mm Hg/min). In patients at rest, neither single nor combined therapy altered global or regional left ventricular ejection fractions (EFs). Verapamil, but not propranolol, increased (p < .05) cardiac volumes of resting subjects; used in combination, no further increase in LV volume occurred. With placebo, exercise global EF did not decrease from the level at rest and therefore no drug effect could be demonstrated for this parameter of LV function. By an evaluation of normalized regional EF measurements the combination was shown to reduce exerciseinduced hypokinesis (placebo 52 ± 20%, combination 61 + 23%; p < .01). No significant improvement was noted with propranolol or verapamil alone; only the combination prevented a significant increase in end-systolic and end-diastolic volumes during exercise. Thus, propranolol and verapamil, used alone in moderate doses, exert no beneficial effect on exercise LV function as measured by EF and volume changes, and resting function deteriorates slightly with verapamil. Compared with single-drug therapy, the combination causes no further change in LV function of resting subjects and improves exercise function. This improvement was most likely due to a reduction in myocardial oxygen demand. Circulation 68, No. 6, 1280No. 6, -1289No. 6, , 1983 COMBINATION THERAPY with /8-adrenergic-receptor antagonists and nitrates is a well-established part of the treatment of chronic exertional angina. Recently, reports have shown that calcium-channel antagonists such as verapamil have antianginal properties comparable to those of propranolol.'-1 Moreover, in selected patients, the combination of propranolol and

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“…Data available from a study in which patients were pretreated with equal doses of propranolol before MDCT and CMR evaluation did not demonstrate any significant difference in stroke volume or EF between modalities [16]. Prior studies examining the acute effect of blockade on ventricular function did not demonstrate a significant change in LVEF but were small, used less sensitive methods, and were underpowered to detect the small differences noted between CMR and MDCT [17,18]. This suggests that the methods of measurement with MDCT may alter the physiology being evaluated; this invites further investigation.…”

Section: Accuracy and Validation Of Mdct And Cmrmentioning

confidence: 97%

Assessment of ventricular structure and function with multidetector CT and MRI

Sibley

Lima

2008

Curr Cardiol Rep

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Accurate, noninvasive assessment of ventricular function is fundamental to providing excellent care to patients with cardiovascular diseases. Three-dimensional imaging using cardiac magnetic resonance (CMR) permits the measurement of ventricular structure and function with such precision and accuracy that it now serves as the standard of reference for this purpose. Multidetector CT (MDCT) permits similar three-dimensional reconstruction and measurement of ventricular function. Available data indicate there is good agreement between MDCT and CMR measurements of ventricular function. Patients with cardiomyopathy and distorted ventricles stand to benefit the most from these techniques, particularly with the possibility of combined noninvasive angiography and systolic function assessment with MDCT.

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Effect of oral propranolol on rest and exercise left ventricular ejection fraction, volumes, and segmental wall motion in patients with angina pectoris. Assessment with equilibrium gated blood pool imaging.

Cited by 41 publications

References 31 publications

Effects of nicardipine on cardiac volume at rest and during exercise‐ induced angina.

Effects of nicardipine on cardiac volume at rest and during exercise‐ induced angina.

Comparative effects of propranolol and verapamil alone and in combination on left ventricular function and volumes in patients with chronic exertional angina: a double-blind, placebo-controlled, randomized, crossover study with radionuclide ventriculography.

Assessment of ventricular structure and function with multidetector CT and MRI

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