Improvement of Exercise-Induced Left Ventricular Dysfunction With Oral Propranolol in Patients With Coronary Heart Disease
ALEXANDER
BATTLER,
MD*
JOHN ROSS, Jr., MD, FACC ROBERT SLUTSKY, MD MATTHIAS WILLIAM VICTOR
PFISTERER, ASHBURN, FROELICHER,
MD
MD MD,
FACC
San Diego, California
From the Division of Cardiology, Department of Medicine and the Division of Nuclear Medicine, Department of Radiology, University of California, San Diego, California. This work was supported by Specialized Center of Research on lschemic Heart Disease, Research Grant HL 17662 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. Manuscript received January 16, 1979; revised manuscript received March 27, 1979, accepted April 2, 1979. Present address: Heart Institute. The Chaim Sheba Medical Center, Tel Hashomer, Israel. Address for reprints: John Ross, Jr., MD, Division of Cardiokqy, Department of Medicine, M913, University of California, San Diego, La Jolla, California 92093. l
316
August
1979
The effect of propranolol on global cardiac function during exercise was analyzed with equilibrium fadlonuclide angiography In 10 patients with ischemic heart disease. All patients had angina pectoris and S-T segment depression of more than 0.1 mv during treadmill exercise when not taking propranolol. Each patient was stressed with supine bicycle exercise to the same work load on a maintenance dose of propranolol (120 to 400 mg/day) and on a second occasion without the drug, the two tests being separated by an average of 16 days. The mean heart rate was reduced both at rest and during exercise after propranolol, but propranolol caused no significant reduction of the left ventricular ejection fraction at rest. In the study without admlnlstratlon of propranolol the average ejection fraction during exercise decreased from 0.56 f 0.09 (standard deviation) to 0.50 f 0.14. Wtth propranolol, the ejection fraction was Improved from the control value In every pattent, the average value during peak exercise reaching 0.60 f 0.15. Thus, the average ejection fraction Increased by 22 percent (f12 percent) relative to the value during the same exercise without propranolol (P
ALEXANDER
BATTLER,
MD*
JOHN ROSS, Jr., MD, FACC ROBERT SLUTSKY, MD MATTHIAS WILLIAM VICTOR
PFISTERER, ASHBURN, FROELICHER,
MD
MD MD,
FACC
San Diego, California
From the Division of Cardiology, Department of Medicine and the Division of Nuclear Medicine, Department of Radiology, University of California, San Diego, California. This work was supported by Specialized Center of Research on lschemic Heart Disease, Research Grant HL 17662 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. Manuscript received January 16, 1979; revised manuscript received March 27, 1979, accepted April 2, 1979. Present address: Heart Institute. The Chaim Sheba Medical Center, Tel Hashomer, Israel. Address for reprints: John Ross, Jr., MD, Division of Cardiokqy, Department of Medicine, M913, University of California, San Diego, La Jolla, California 92093. l
316
August
1979
The effect of propranolol on global cardiac function during exercise was analyzed with equilibrium fadlonuclide angiography In 10 patients with ischemic heart disease. All patients had angina pectoris and S-T segment depression of more than 0.1 mv during treadmill exercise when not taking propranolol. Each patient was stressed with supine bicycle exercise to the same work load on a maintenance dose of propranolol (120 to 400 mg/day) and on a second occasion without the drug, the two tests being separated by an average of 16 days. The mean heart rate was reduced both at rest and during exercise after propranolol, but propranolol caused no significant reduction of the left ventricular ejection fraction at rest. In the study without admlnlstratlon of propranolol the average ejection fraction during exercise decreased from 0.56 f 0.09 (standard deviation) to 0.50 f 0.14. Wtth propranolol, the ejection fraction was Improved from the control value In every pattent, the average value during peak exercise reaching 0.60 f 0.15. Thus, the average ejection fraction Increased by 22 percent (f12 percent) relative to the value during the same exercise without propranolol (P
