Acute effects of celiprolol on angiographically normal and stenotic coronary arteries

Unselective and beta 1-selective beta-blockers may induce vasoconstriction of normal and stenotic epicardial coronary arteries. To analyze the influence of the "vasodilatory" beta-blocker celiprolol on coronary vasomotility, 0.4 mg celiprolol/kg were intravenously infused over 4 minutes in 13 patients with coronary artery disease. Coronary angiograms were taken before (control) and at 4, 6, 8, 10, 15, and 20 minutes after the onset of infusion and 4 minutes after final sublingual administration of 0.4 mg nitroglycerin. Quantitative analysis of cinefilms demonstrated no significant diameter changes in angiographically normal coronary segments and stenoses. The vasodilatory capacity of normal segments (18 +/- 12%; p < 0.001) and stenoses (17 +/- 14%; p < 0.01) was proven by nitroglycerin. Systolic blood pressure, heart rate, and pulmonary wedge pressure revealed no significant changes with celiprolol. Thus, celiprolol exerts no vasoconstricting effects on angiographically normal and stenotic coronary arteries.