Short-Term Effects of Celiprolol on Blood Pressure and Left Ventricular Performance in Hypertensive Cardiomyopathy

Abstract

Summary: Celiprolol (C) is a new selective β1-blocker with partial β2-agonistic activity. The purpose of this study was to explore its antihypertensive efficacy and its short-term effect on systemic vascular resistances (SVR), cardiac output (CO), left ventricular ejection fraction (LVEF), and left ventricular diastolic performance (LVDP). The Doppler technique was used. In an openlabel study, 20 hypertensive patients (15 males, 5 females, age range of 29-68 years) with left ventricular hypertrophy detected by echography were daily treated with 400 mg of C in a single dose, for a period of 4 weeks. C reduced significantly the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) (158 ± 12 vs. 142 ± 11 mm Hg, p <0.05 and 101 ± 6 vs. 87 ± 4 mm Hg, p<0.001, respectively) with a decrease in heart rate (74 ± 12 vs. 67 ± 8 beats/min, p = NS). The SVR decreased significantly (2,050 ± 22 vs. 1,495 ± 23 dyn/s/cm5, p < 0.001) with a slight but not significant increase in the CO (4.5 ± 0.69 vs. 5.11 ± 0.82 L/min). The LVEF did not decrease significantly (58 ± 5 vs. 56.9 ± 6 %, p = NS) while the LVDP was modified favorably, significantly reducing the early diastolic deceleration time (EDDT) (199 ± 61 vs. 132 ± 80 ms, p < 0.01) and reducing the isovolumetric relaxation time (IVRT) (167 ± 16 vs. 117 ± 23 ms, p < 0.001). It can be concluded that C is an effective antihypertensive drug that performs this action mainly through a marked reduction in the SVR, with an improvement in the LVDP and without modifying the LVEF. The shortening of the IVRT proved to be the best individual parameter for evaluating the short-term efficacy of the treatment in the improvement of the LVDP