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Analysis of left ventricular function by radionuclide ventriculogram in hypertensive patients treated with atenolol
E J Marcó1, F Otero, A M Dopico
1Instituto de Cardiología, Academia Nacional de Medicina, Buenos Aires, Argentina.
Insights
Atenolol, used for hypertension, significantly lowered blood pressure and heart rate but impaired left ventricular relaxation. This study highlights potential adverse myocardial effects despite therapeutic benefits.
Area of Science:
- Cardiology
- Pharmacology
- Cardiovascular Physiology
Background:
- Essential hypertension is a prevalent condition requiring effective management.
- Beta-blockers, like atenolol, are commonly prescribed for hypertension.
- Understanding the myocardial effects of atenolol is crucial for patient care.
Purpose of the Study:
- To investigate the impact of daily oral atenolol on myocardial function in patients with essential hypertension.
- To assess changes in cardiac performance at rest and during exercise.
Main Methods:
- Utilized radionuclide multi-triggered ventriculography to evaluate cardiac function.
- Monitored systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), ejection fraction (EF), peak filling rate (PFR), and peak ejection rate (PER).
- Assessed 10 patients with mild to moderate essential hypertension over two months of 100 mg/day atenolol treatment.
Main Results:
- Atenolol significantly reduced SBP and DBP at rest and during exercise.
- Heart rate (HR) decreased both at rest and during exercise.
- Peak filling rate (PFR) and peak ejection rate (PER) were significantly diminished.
- No significant alterations in ejection fraction (EF) were observed.
Conclusions:
- Daily oral atenolol effectively lowers blood pressure and heart rate in hypertensive patients.
- Atenolol treatment impaired left ventricular relaxation, indicated by reduced PFR and PER.
- These findings suggest potential adverse myocardial effects of atenolol independent of its blood pressure-lowering action.
Abstract:
The myocardial effects of a daily oral dose of atenolol were studied by radionuclide multi-triggered ventriculogram in 10 patients (7 men and 3 women) with mild to moderate essential hypertension, aged 29 to 53 years (mean 43) at rest and during exercise. Before and after two months of treatment with 100 mg/day orally of atenolol, the following variables were recorded: systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), ejection fraction (EF), peak filling rate (PFR) and peak ejection rate (PER). Beta-blockade treatment caused a significant drop in SBP and DBP, both at rest and during exercise; HR slowed down at rest and during exercise. PFR diminished at rest and during exercise. PER was reduced at rest and during exercise (p less than 0.001). No significant changes in EF were observed after treatment with atenolol. In conclusion, atenolol impaired left ventricular relaxation in spite of the drop in blood pressure.