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Acebutolol and left ventricular function: assessment by radionuclide angiography
Insights
Acebutolol, a cardioselective beta blocker, improved resting and exercise left ventricular function in patients with chronic angina pectoris. This effective antianginal treatment demonstrated safety and enhanced cardiac performance without significant adverse effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Chronic angina pectoris affects global and regional left ventricular function.
- Beta-blockers are commonly used for angina management.
Purpose of the Study:
- To evaluate the effects of acebutolol on left ventricular function in patients with chronic angina.
- To assess the safety and efficacy of acebutolol in improving cardiac performance during rest and exercise.
Main Methods:
- 26 patients with chronic angina underwent radionuclide angiography at rest and during maximal exercise.
- Patients received either placebo or oral acebutolol (400 mg three times daily).
- Global and regional left ventricular function were assessed using ejection fraction and wall motion analysis.
Main Results:
- Acebutolol showed a statistically significant improvement in resting ejection fraction (51% to 54%, p<0.05).
- No patient experienced a significant decrease in resting ejection fraction; only one patient had fluid retention.
- Exercise ejection fraction remained similar, but acebutolol normalized exercise-induced ejection fraction response in 4 patients and regional wall motion abnormalities in 5 patients.
Conclusions:
- Cardioselective beta blockade with acebutolol is safe in effective antianginal doses.
- Acebutolol may improve both resting and exercise left ventricular function in patients with chronic angina.
- Acebutolol offers a potential therapeutic benefit beyond symptom relief in angina management.
Abstract:
We assessed the effects of acebutolol, a cardioselective beta blocker, on global and regional left ventricular function in 26 patients with chronic angina pectoris. All patients underwent rest and maximal supine bicycle exercise radionuclide angiography while on placebo and oral acebutolol (400 mg three times a day). Resting ejection fraction on placebo was 51 +/- 3% and on acebutolol was 54 +/- 3% (p less than 0.05). No resting ejection fraction decreased greater than or equal to 7%. Only one patient (resting ejection fraction 28% on placebo and 21% on acebutolol) developed signs of fluid retention. Exercise nuclear studies on placebo revealed responses consistent with coronary artery disease (abnormal ejection fraction response to exercise and regional wall motion abnormalities) in 24 of 26 patients. Peak exercise ejection fraction was of the same order on placebo and acebutolol (51 +/- 3% and 54 +/- 3%, p = NS). In four patients the ejection fraction response to exercise became normal and in five patients all regional wall motion abnormalities became normal on acebutolol. Cardioselective beta blockade with acebutolol in effective antianginal doses is safe and may improve resting and exercise ventricular function.