Effects of bopindolol on left ventricular function during exercise in patients with coronary artery disease

Bopindolol is a new beta blocker with a long duration of action. We examined the haemodynamic effects of multiple oral doses of 2 mg in 12 male patients, with coronary artery disease. Placebo was given for 7 days followed by bopindolol 2 mg daily for 14 days. Scintigraphic ventriculography combined with an exercise test was carried out at baseline before treatment with bopindolol, and repeated after 7 and 14 days treatment. On day 7 the measurements were made 2 h after therapy (i.e., when plasma levels were maximal) and on day 14 when plasma levels were lowest (24 h after the last dose). The results showed that bopindolol had little effect on blood pressure or heart rate at rest in these normotensive patients but that both parameters measured after exercise were statistically significantly reduced (p less than 0.001). There was little difference between the effect seen 2 h after therapy and the effect seen 24 h after therapy, thus, demonstrating the long duration of action. The mean ejection fraction was not changed by bopindolol either at rest or after exercise but individual patients who responded to exercise with a fall in ejection fraction before treatment did not do so following treatment. These were mainly patients with 2 and 3 artery disease and the failure of the mean ejection fraction to show this protective effect was probably due to the predominance in our patients of those with mild single vessel disease who did not react adversely to exercise. We conclude that bopindolol protects the myocardium against ischaemia and that the effect lasts for at least 24 h when therapy is given once daily.