EFFECTS OF CELIPROLOL ON CARDIAC-FUNCTION IN PATIENTS WITH CORONARY HEART-DISEASE - A DOPPLER STUDY

Celiprolol, a selective beta-blocker with special beta(2)-receptor sti mulating and vasodilating properties appears to be more advantageous i n ischemic patients with comprised ejection fraction. The influence of celiprolol on systolic and diastolic function in 20 patients sufferin g from coronary artery disease with reduced ejection fraction (EF, mea n 24%) in NYWA III was studied using Doppler echocardiography. Systoli c parameters like end-systolic dimension, ejection fraction, fractiona l shortening, mean velocity of circumferential fiber shortening and di astolic parameters like early and late mitral diastolic inflow velocit ies, deceleration time of early diastolic now velocity, isovolumic ral axation time and pulmonary venous flow velocity were measured before a nd after oral administration of 400 mg celiprolol taken on empty stoma ch. Significant increases in early and late diastolic inflow velocity, pulmonary diastolic venous flow velocity (all p < 0.05) and highly si gnificant prolongation of deceleration time of early diastolic inflow (p < 0.01) were observed. A highly significant increase in ejection fr action (p < 0.01) and a rise in cardiac index with a significant reduc tion of total peripheral resistance (p < 0.05) indicated an improved s ystolic function and hemodynamic status. The changes in diastolic func tion parameters could have resulted from an improved compliance? an af terload reduction and a preload optimization following the enhanced sy stolic function or due to the direct effect on intrinsic diastolic pro perties. The significantly I educed double product (p < 0.05) pointed to an economized myocardial performance. All these changes appear to r esult in global advantage to this class of ischemic patients.