The effect of beta-blockers metoprolol and atenolol on left ventricular early remodeling in patients with ST segment elevation acute coronary syndrome

Effect of metoprolol and atenolol on early remodeling of the left ventricle in patients with acute c oronary syndrome with ST segment elevation. The purpose of the work was to study the effect of cardio selective betablockers on the overall and regional contractility of the left ventricle in patients with acute coronary syndrome with ST segment elevation. Seventy patients aged 38� 65 years were observed. The conventional treatment included anticoagulants, antiagregants, statins, betablockers, nitrates, ACE inhibitors. The patients were randomly divided into 2 groups, 35 each, on atenolol and metoprolol therapies, respectively. Echocardiography was per formed on the first day after revascularization with assessment of cardiac volumes and hemodynamic indices. After stabilization of the patients a stress� echocardiography with dobutamine was performed. Di sorders of local contractility were differentiated by 4 grade scale: hyperkinesis � 0, normokinesis � 1, hypokinesis � 2 , akinesis � 3, dyskinesis � 4. Early use of metoprolol or atenolo l betablockers allowed the decrease of reperfusion impairment of the myocardium and prevented left ventricle remodeling due to preservation of viable myocardial zones. Metoprolol was superior to atenolol in preventing left ventricle remodeling.