Different effects of calcium antagonist and beta-blocker therapy on left-ventricular diastolic function in ischemic heart disease. A direct comparison of the impact of mibefradil and atenolol

C Hassager, K Thygesen, P Grande, J Fischer Hansen, H Mickley, I Gustafsson, K Skagen, F Steensgaard-Hansen

2 Citations (Scopus)

Abstract

OBJECTIVE: To compare the effect of a calcium antagonist and a beta-blocker on left-ventricular diastolic function in patients with ischemic heart disease.

METHODS: 138 patients with chronic stable angina pectoris were randomized in a multicenter, double-blind trial to treatment with either mibefradil or atenolol for 6 weeks (50 mg once daily for 2 weeks followed by 100 mg once daily for 4 weeks). The ratio between early (E) and late (A) diastolic mitral flow velocities (E/A), the E wave deceleration time (DT) and the left ventricular isovolumetric relaxation time (IRT) were measured by Doppler echocardiography as parameters of left-ventricular diastolic function initially, after 4 and after 6 weeks of treatment.

RESULTS: Mibefradil did not change the E/A ratio significantly (+4%, NS), while atenolol treatment resulted in a significant increase in the E/A ratio (+20%, p < 0.001). Mibefradil treatment, on the other hand, resulted in a significant decrease (-8%, p < 0.001) in IRT, while atenolol treatment did not change IRT. Neither mibefradil nor atenolol treatment changed DT significantly.

CONCLUSIONS: Both mibefradil and atenolol treatment significantly improves echocardiographic indices of left-ventricular diastolic function in patients with chronic stable angina. However, they affect different parameters and thus apparently act through different mechanisms.

Original languageEnglish
JournalCardiology
Volume96
Issue number2
Pages (from-to)65-71
Number of pages7
ISSN0008-6312
Publication statusPublished - 2001

Keywords

  • Adrenergic beta-Antagonists
  • Aged
  • Angina Pectoris
  • Atenolol
  • Blood Flow Velocity
  • Blood Pressure
  • Calcium Channel Blockers
  • Diastole
  • Double-Blind Method
  • Echocardiography, Doppler
  • Female
  • Heart Rate
  • Heart Septum
  • Humans
  • Male
  • Mibefradil
  • Middle Aged
  • Mitral Valve
  • Time Factors
  • Ventricular Function, Left
  • Clinical Trial
  • Comparative Study
  • Journal Article
  • Multicenter Study
  • Randomized Controlled Trial

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