ACUTE HEMODYNAMIC PROFILE OF CELIPROLOL IN PATIENTS WITH CORONARY HEART-DISEASE AND HYPERTENSION - A DOUBLE-BLIND COMPARISON WITH METOPROLOL

Celiprolol is a 'third generation' beta-blocking agent which is claimed to avoid problems associated with simpler beta-blockers, such as vasoconstriction, bronchoconstriction and myocardial depression. A double-blind randomized study was undertaken in 30 patients with coronary artery disease and hypertension to compare the haemodynamic effects of single intravenous doses of 0.15 mg kg-1 celiprolol (N= 16) and metoprolol (N= 14). Following celiprolol administration, the tendency was for myocardial function to improve or remain unchanged; left ventricular end-systolic volume and ejection fraction improved significantly (P<0.05). However, following metoprolol administration, the tendency was for myocardial function to deteriorate, with significant falls in cardiac output (P<0.05), ejection fraction (P<0.05) and velocity of circumferential shortening (P<0.01). There was a tendency for peripheral resistance to fall slightly with celiprolol but to rise markedly with metoprolol (pNS). Left ventricular pressure-volume loops showed improved performance with celiprolol and deterioration with metoprolol. Both drugs resulted in increases in coronary flow and myocardial oxygen consumption (P<0.05). Metoprolol, but not celiprolol, resulted in some deterioration in regional left ventricular wall motion (P<0.05). Celiprolol appears to be haemodynamically advantageous compared to metoprolol in patients with coronary artery disease and hypertension. © 1991 The European Society of Cardiology.