Treatment of spontaneous angina pectoris with beta blocking agents A clinical, electrocardiographic, and haemodynamic appraisal

Maurizio Guazzi, Cesare Fiorentini, Alvise Polese, Fabio Magrini, Maria T. Olivari

Research output: Contribution to journalArticlepeer-review

Abstract

Propranolol and practolol were tested in patients with repeated daily occurrence of spontaneous angina. Twenty one showed ST segment depression (type I) and 15 ST segment elevation (type II) during angina. The efficacy of the treatment was evaluated in subjective (number of reported episodes of pain) and cijective terms (number of episodes of electrocardiographic abnormalities documented during periods of continuous recording): practolol was fully effective in 42 per cent and propranolol in 38 per cent of type I cases; in type II angina 73 per cent of the cases fully responded to propranolol, none of the patients in this group given practolol improved. The study also showed that: (a) the effects on angina are strictly dose-dependent, and optimal results are achieved at individualized doses; (b) within the same subject the response may be preferential to one betablocker as opposed to the other; (c) propranolol is more effective in type II angina; (d) the occurrence of heart failure is uncommon even with high doses of beta blockers; (e) the relief of angina is due to prevention of ischaemia and not to a placebo or anaesthetic effect; (f) the prevention of ischaemia is not adequately explained by reduction of the mechanical effort and the oxygen need of the myocardium; (g) the antianginal effect is possibly dissociated from the beta blockade of the heart. The hypothesis that beta-blocking agents influence the coronary vasomotion is discussed.

Original languageEnglish
Pages (from-to)1235-1245
Number of pages11
JournalHeart
Volume37
Issue number12
DOIs
Publication statusPublished - 1975

ASJC Scopus subject areas

  • Gastroenterology
  • Cardiology and Cardiovascular Medicine

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