Why the study?
Do intravenous metoprolol and H 87/07 improve hemodynamic parameters during exercise in patients with ischemic heart disease?
Do intravenous metoprolol and H 87/07 improve hemodynamic parameters during exercise in patients with ischemic heart disease?
Intravenous metoprolol is a potent beta-adrenoceptive antagonist that significantly reduces left ventricular work and heart rate during exercise in patients with ischemic heart disease.
Metoprolol reduces LV work and output during exercise in IHD; confirms beta-blockade efficacy and challenges H 87/07 equivalence.
Nineteen patients with ischemic heart disease were randomized into two groups and received either metoprolol or H 87/07. Heart catheterization was performed, and the groups were studied at rest and during exercise--before and after intravenous drug administration. During work metoprolol gave a statistically significant reduction in left ventricular work (expressed as pressure-rate product) of about 20%, mainly depending on a reduction in heart rate. Cardiac output decreased by 21%. Stroke volume was almost unchanged. The abnormal increase in left ventricular filling pressure during work was slightly, but not significantly, reduced by the drug. For H 87/07 no significant changes were found in the corresponding variables. This seems, however, to depend on an inadequate dosage, since not even the heart rate during work was significantly reduced. In conclusion, in the doses used metoprolol has been shown to be a potent beta-adrenoceptive antagonist in contrast to H 87/07.
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Adolfsson et al. (1976) studied this question.
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