August 1, 1993Journal of Cardiovascular Pharmacology
Effects of D-Nebivolol and L-Nebivolol on Left Ventricular Systolic and Diastolic Function
Why the study?
Does the racemic mixture of nebivolol (D-L-nebivolol) improve left ventricular systolic and diastolic function compared to its isolated enantiomers or atenolol in patients with ischemic heart disease?
Population
40 patients with ischemic heart disease and previous myocardial infarction.
Comparison
Intravenous infusion of D-nebivolol… vs Atenolol 15 mg intravenous infusion and baseline…
Design
Other
Follow-up
Immediate (before and after intravenous infusion)
Authors
Discussion
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Implication
May support racemic nebivolol for LV preservation versus atenolol; hypothesis-generating and requires randomized confirmation.
Structured PICO
Does the racemic mixture of nebivolol (D-L-nebivolol) improve left ventricular systolic and diastolic function compared to its isolated enantiomers or atenolol in patients with ischemic heart disease?
P
Population
40 patients with ischemic heart disease and previous myocardial infarction.
I
Intervention
Intravenous infusion of D-nebivolol, L-nebivolol (1.25-2.5 mg), or racemic D-L-nebivolol (2.5 mg).
C
Comparator
Atenolol 15 mg intravenous infusion and baseline measurements.
O
Outcome
Left ventricular systolic and diastolic function (including heart rate, peak (+) dP/dt, cardiac index, ejection fraction, and diastolic distensibility).surrogate
The beneficial effects of nebivolol on left ventricular systolic and diastolic hemodynamics require the racemic mixture of both D- and L-enantiomers, which outperforms atenolol in preserving cardiac output and ejection fraction.
Cite This Study
Stoleru et al. (1993) studied this question.