Why the study?
Does combined alpha-blockade and beta-blockade with labetalol improve acute haemodynamic effects compared to beta-blockade with propranolol in patients with coronary artery disease?
Does combined alpha-blockade and beta-blockade with labetalol improve acute haemodynamic effects compared to beta-blockade with propranolol in patients with coronary artery disease?
Labetalol (combined alpha- and beta-blockade) causes less acute depression of left ventricular function than propranolol (beta-blockade alone) in patients with coronary artery disease.
Labetalol may be preferred over propranolol in CAD to limit LV dysfunction; extends evidence for combined alpha-beta blockade advantages.
The acute haemodynamic effects of beta-blockade with propranolol and combined alpha-blockade and beta-blockade with labetalol were compared in a randomised study in 12 patients with coronary artery disease proved by angiography. Propranolol induced significantly greater depression of left ventricular function both at rest and during exercise than labetalol. This difference was probably attributable to the vasodilator activity of labetalol and the associated reduction in afterload offsetting the haemodynamic disadvantages of blockade of cardiac beta-adrenoceptors alone. The haemodynamic advantages of combined alpha-blockade and beta-blockade over beta-blockade alone may thus have therapeutic implications for the use of these treatments in patients with coronary heart disease.
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Taylor et al. (1982) studied this question.
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