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Left ventricular function and beta-blockers: does intrinsic sympathomimetic activity have any influence during
R J Northcote1, M B Cooke, D Ballantyne
1Department of Medical Cardiology, Victoria Infirmary, Glasgow, Scotland.
Cardiovascular Drugs and Therapy
|November 1, 1988
Summary
Propranolol improved left ventricular function in patients with stable angina pectoris, while pindolol did not. This suggests intrinsic sympathomimetic activity offers no advantage for long-term beta-blocker therapy in these patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Stable angina pectoris management often involves beta-blockers.
- Understanding the long-term effects of different beta-blockers on cardiac function is crucial.
Purpose of the Study:
- To compare the chronic effects of propranolol and pindolol on left ventricular function in male patients with stable angina pectoris.
- To evaluate the role of intrinsic sympathomimetic activity in beta-blocker therapy for angina.
Main Methods:
- A comparative study involving 21 patients on propranolol and 19 on pindolol.
- Serial radionuclide ventriculography at rest and during cold pressor testing.
- Assessment of ejection fraction and New York Heart Association classification.
Main Results:
- Both propranolol and pindolol improved angina symptoms.
- Propranolol significantly increased resting ejection fraction from 49% to 55% at 26 weeks.
- Pindolol showed no significant change in resting ejection fraction; propranolol improved subnormal ejection fractions (39% to 51%).
Conclusions:
- Propranolol enhances left ventricular performance in patients with stable angina pectoris.
- Intrinsic sympathomimetic activity of pindolol does not offer an advantage in preserving or improving left ventricular function over extended periods.