Comparative effects of propranolol and verapamil alone and in combination on left ventricular function and volumes in patients with chronic exertional angina: a double-blind, placebo-controlled, randomized, crossover study with radionuclide ventriculography

Journal Article · Thu Dec 01 04:00:00 EST 1983 · Circulation; (United States)

DOI:https://doi.org/10.1161/01.CIR.68.6.1280· OSTI ID:6746854

Johnston, D L; Gebhardt, V A; Donald, A; Kostuk, W J

With the use of equilibrium radionuclide ventriculography the effects on left ventricular (LV) function of 160 mg oral propranolol daily and 360 mg verapamil daily alone and in combination were compared in 18 patients with chronic exertional angina. A randomized, double-blind, placebo-controlled, crossover protocol was used. The reduction in exercise rate-pressure product induced by the combination (118 +/- 28 mm Hg/min) was significantly greater than that by propranolol (135 +/- 27 mm Hg/min) or verapamil alone (163 +/- 28 mm Hg/min). In patients at rest, neither single nor combined therapy altered global or regional left ventricular ejection fractions (EFs). Verapamil, but not propranolol, increased cardiac volumes of resting subjects; used in combination, no further increase in LV volume occurred. With placebo, exercise global EF did not decrease from the level at rest and therefore no drug effect could be demonstrated for this parameter of LV function. By an evaluation of normalized regional EF measurements the combination was shown to reduce exercise-induced hypokinesis (placebo 52 +/- 20%, combination 61 +/- 23%. No significant improvement was noted with propranolol or verapamil alone; only the combination prevented a significant increase in end-systolic and end-diastolic volumes during exercise. Thus, propranolol and verapamil, used alone in moderate doses, exert no beneficial effect on exercise LV function as measured by EF and volume changes, and resting function deteriorates slightly with verapamil.

• Research Organization: Univ. Hospital, London, Ontario
• OSTI ID: 6746854
• Journal Information: Circulation; (United States), Journal Name: Circulation; (United States) Vol. 68:6; ISSN CIRCA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
AUTONOMIC NERVOUS SYSTEM AGENTS
BLOOD FLOW
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CHEMOTHERAPY
COUNTING TECHNIQUES
DIAGNOSIS
DISEASES
DRUGS
EVALUATION
HEART
MEASURING METHODS
ORGANS
RADIOISOTOPE SCANNING
SYMPATHOLYTICS
THERAPY
VASODILATORS