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Effect of timolol on exercise-induced reduction in regional ejection fraction in patients with coronary artery

E J Brown, B L Holman, J Wynne

    Chest
    |September 1, 1983
    PubMed

    Insights

    Timolol, a beta-adrenergic blocking agent, significantly improved exercise-induced left ventricular dysfunction in patients with coronary artery disease. This study highlights timolol's beneficial anti-ischemic effects.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Exercise Physiology

    Background:

    • Coronary artery disease (CAD) frequently leads to exercise-induced left ventricular (LV) wall motion abnormalities.
    • Beta-adrenergic blocking agents are commonly used in CAD management, but their specific effects on regional LV function during stress require further elucidation.

    Purpose of the Study:

    • To evaluate the impact of timolol, a beta-adrenergic blocking agent, on exercise-induced left ventricular wall motion abnormalities in patients with chronic coronary artery disease.
    • To assess the anti-ischemic potential of timolol in this patient population.

    Main Methods:

    • Nine patients with chronic, angiographically-documented coronary artery disease were studied.
    • A computerized gated radionuclide ventriculography technique was employed to measure regional ejection fractions (apical, anteroseptal, inferoposterior) during exercise.
    • Regional ejection fractions were assessed before and after initiation of timolol therapy (10-30 mg daily).

    Main Results:

    • Exercise induced significant reductions in regional ejection fractions prior to timolol administration (p<0.05 for all regions).
    • Following three days of timolol therapy, these exercise-induced reductions in regional ejection fractions were markedly attenuated (p=NS for all regions).
    • Several individual regions demonstrated increased ejection fraction during exercise after timolol treatment.

    Conclusions:

    • Timolol demonstrates a previously unreported beneficial anti-ischemic effect in patients with coronary artery disease.
    • Timolol effectively attenuates exercise-induced left ventricular wall motion abnormalities, suggesting a protective role against myocardial ischemia.

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