Effect of atenolol on left ventricular function in hypertensive patients.

Abstract

No information is available about the effects of oral atenolol, a cardioselective beta-adrenergic blocking agent with no intrinsic sympathomimetic activity, on left ventricular function. Atenolol, 100 mg/day, was given to 12 hypertensive patients for 8 weeks, and its effects on mean arterial pressure (MAP), cardiac index (CI) and ejection indexes of myocardial performance were examined by echocardiography. Echocardiographic studies were performed before treatment, after 4 weeks of placebo, and repeated after 4 and 8 weeks of atenolol therapy. MAP fell by 14% and 21% after 4 and 8 weeks, respectively. CI fell by 22% and 20% and stroke index (SI) fell by 11% and 7%. Calculated peripheral resistance did not change significantly. Fractional shortening, ejection fraction and normalized mean rate of circumferential fiber shortening did not change. The normalized mean posterior wall velocity decreased after 4 weeks but returned to pretreatment levels after 8 weeks. The septal velocity increased after 8 weeks. End-diastolic volume index (EDVI) did not change, and there was no relationship between changes in heart rate and EDVI. The study shows that atenolol in the resting state has no effect on certain echocardiographic indexes of left ventricular (LV) function when given orally to hypertensive patients with normal LV size and function. The reduction in CI and SI were presumably secondary to a decrease in cardiac venous filling.