To assess acute hemodynamic effects of
bisoprolol on left ventricular hemodynamics at rest and during exercise, 16 patients with documented chronic
ischemic heart disease were studied and compared with patients after administration of
metoprolol and
bufuralol. Simultaneous right heart catheterization and
radionuclide angiocardiography were performed at rest and during exercise before and after
drug administration.
Bisoprolol was given orally to 16 patients, six receiving 5 mg, and 10 patients receiving 20 mg.
Metoprolol was injected intravenously in a dose of 0.15 mg/kg to another 16 patients, and 30 mg
bufuralol were given orally to 10 patients. The hemodynamic profiles of all three compounds were similar to that previously described after acute beta-blockade. All three drugs tested and compared showed a marked negative chronotropic effect, while there were slight differences in the negative inotropic and blood pressure lowering effect.
Bisoprolol induced only mild negative inotropic changes, which were barely detectable after the 5 mg dose. The negative inotropic changes were more pronounced after
metoprolol, and were partly balanced by the vasodilating properties of
bufuralol. Thus,
bisoprolol showed a significantly reduced rate pressure product with only a relatively mild negative inotropic effect. Based on these observations, even the higher dose of 20 mg
bisoprolol seems to be hemodynamically safe for clinical application.