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Hemodynamic effects of celiprolol in patients with ischemic and non-ischemic cardiomyopathy
M G Hennersdorf1, C Perings, E G Vester
1Department of Cardiology, Pneumology and Angiology, Medical Clinic and Policlinic B, Heinrich-Heine University, Düsseldorf, Germany. hennersd@uni-duesseldorf.de
Insights
Celiprolol therapy significantly improved ejection fraction in patients with congestive heart failure. Patients with non-ischemic cardiomyopathy (niCMP) showed greater hemodynamic improvements than those with ischemic cardiomyopathy (iCMP).
Area of Science:
- Cardiology
- Pharmacology
Background:
- Congestive heart failure (CHF) presents significant challenges in management.
- Differentiating between ischemic (iCMP) and non-ischemic (niCMP) origins is crucial for treatment strategies.
Purpose of the Study:
- To evaluate the effects of celiprolol, a beta-1 antagonist with beta-2 agonistic activity, on hemodynamic and electrocardiographic parameters in CHF patients.
- To compare the efficacy of celiprolol in patients with iCMP versus niCMP.
Main Methods:
- Sixteen CHF patients (9 iCMP, 7 niCMP) were enrolled.
- Evaluations included radionuclide ventriculography, right heart catheterization, late potential analysis, and heart rate variability.
- Patients received a 3-month course of celiprolol (100 mg/day for 3 days, then 200 mg/day).
Main Results:
- A significant improvement in left ventricular ejection fraction was observed in all patients after 3 months.
- Hemodynamic improvements were more pronounced in the niCMP group.
- Heart rate remained stable in the niCMP group, unlike in the iCMP group.
Conclusions:
- Celiprolol, as an add-on therapy, significantly enhances ejection fraction in CHF patients.
- Patients with niCMP appear to benefit more from this beta-blocking therapy compared to those with iCMP.
Abstract:
In this study, the effect of celiprolol (beta-1-antagonist with beta-2-agonistic activity) on hemodynamic and electrocardiographic parameters of patients with congestive heart failure due to ischemic (iCMP) and non-ischemic (niCMP) origin should be evaluated. Sixteen patients were included into the study, nine with iCMP, seven with niCMP. All patients were investigated by radionuclide ventriculography (99mTc), right heart floating catheterization, and late potential analysis and measurement of heart rate variability. All patients received 200 mg celiprolol after a 3-day period of 100 mg celiprolol/day. All patients showed, after a follow-up period of 3 months, a significant improvement of the left ventricular ejection fraction. The changes of hemodynamic parameters were more pronounced in patients with niCMP. Heart rate did not decrease in patients with niCMP. A 3-month therapy with celiprolol as an additional therapy to a preexisting heart failure therapy leads to a significant improvement of the ejection fraction in patients with congestive heart failure. Patients with niCMP seemed to profit more from this additional beta-blocking therapy.