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Effect of propranolol on postexercise left ventricular ejection time index

H Boudoulas, P D Ruff, P K Fulkerson

    The American Journal of Cardiology
    |August 1, 1981
    PubMed
    Summary
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    Prolonged net delta left ventricular ejection time after exercise is not a reliable indicator of myocardial ischemia in patients taking propranolol. Beta-blockade significantly increases this measurement, masking potential ischemia.

    Area of Science:

    • Cardiology
    • Exercise Physiology

    Background:

    • Net delta left ventricular ejection time (LVET) prolongation post-exercise is observed in coronary artery disease (CAD).
    • This prolongation is hypothesized to reflect impaired myocardial response to adrenergic stimulation, indicating ischemia.

    Purpose of the Study:

    • To investigate the effect of beta-adrenergic blockade on post-exercise net delta LVET.
    • To determine if net delta LVET can reliably diagnose myocardial ischemia in patients on beta-blockers.

    Main Methods:

    • Nine healthy subjects (Group A) and eight stable angina patients (Group B) underwent treadmill exercise tests.
    • Propranolol (160 mg daily) was administered for 2 days before repeat testing.
    • Patients in Group B were selected for normal pre-propranolol net delta LVET.

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    Main Results:

    • In healthy subjects, post-exercise net delta LVET significantly increased after propranolol (12 ± 4 ms vs. 35 ± 4 ms, p < 0.01).
    • In CAD patients with normal baseline net delta LVET, it also significantly increased post-propranolol (11.5 ± 4 ms vs. 35.3 ± 5 ms, p < 0.01).

    Conclusions:

    • Post-exercise net delta LVET prolongation is not a valid diagnostic marker for myocardial ischemia in patients receiving propranolol therapy.
    • The data support that impaired myocardial response to catecholamines, whether from ischemia or beta-blockade, causes net delta LVET prolongation.