HEMODYNAMIC-RESPONSE TO EXERCISE AFTER PROPRANOLOL IN PATIENTS WITH MITRAL-STENOSIS

Hemodynamic response to exercise before and 10 minutes after propranolol (5 mg intravenously) was studied in 10 young patients with pure mitral stenosis who had normal sinus rhythm and no cardiac failure. After propraholol the mean heart rate and cardiac index at rest were lower than during the control state (respectively, 95 ± 4 versus 82 ± 3 beats/min, P < 0.005; 3.4 ± 0.2 versus 2.8 ± 0.1 liters/min per m2, P < 0.025). As a result, the mean pulmonary wedge pressure and mean mitral valve gradient at rest were lower (respectively, 22 ± 2 versus 18 ± 2 mm Hg, P < 0.005; 24 ± 2 versus 17 ± 2 mm Hg, P < 0.001). During exercise after propranotol the values of pulmonary wedge pressure and mitral valve gradient were lower than control values during exercise (respectively, 39 ± 3 versus 30 ± 2 mm Hg, P < 0.005; 44 ± 3 versus 32 ± 3 mm Hg, P < 0.005), again because of the lower heart rate and cardiac index (130 ± 6 versus 104 ± 6 beats/min, P < 0.001; 4.6 ± 3 versus 3.7 ± 2 liters/ min per m2, P < 0.01). Left ventricular end-diastolic pressure and stroke index showed no significant changes. Thus, propranolol may benefit patients with pure mitral stenosis with sinus rhythm and no cardiac failure whose symptoms occur during those reversible conditions characterized by an increase in heart rate or cardiac output, or both. © 1979.