Acute haemodynamic profile of celiprolol in patients with coronary heart disease and hypertension: a double-blind comparison with metoprolol

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Abstract
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 myocardialfunction to improve or remain unchanged, left ventricular end-svstolic volume and ejection fraction improved sign ficantly (P <0·05). However, following met oprolol administration, the tendency was for myocar dial function to deteriorate, with sign 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 haemodvnamically advantageous compared to metoprolol in patients with coronary artery disease and hypertension.

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