The α1-adrenergic blocker urapidil improves contractile function in patients 3 months after coronary stenting: a randomized, double-blinded study

Abstract Background The recovery of left ventricular function (LVF) after revascularization takes time. α-Adrenergic blockade acutely improves coronary blood flow and LVF, whereas the effects of more prolonged α-adrenergic blockade on LVF recovery after stenting are unknown. Methods In 32 patients (age 58 ± 12 y) with an 82% ± 6% stenosis, ejection fraction (EF) and systolic thickening (%Th) were measured by transthoracic echocardiography before and 30 minutes to 2 hours after revascularization. In a double-blinded protocol, either 200 μg/kg urapidil or placebo was given intravenously, and LVF was measured 10 minutes later. Two hours later, oral treatment with 30 mg/d drug or placebo was started, and LVF measured again after 24 hours and 3 months. Results Before revascularization, EF was 49.4% ± 8.5% (±SD) and 51.3% ± 8.8% in the urapidil-treated and the placebo groups, respectively. Thirty minutes to 2 hours after coronary stenting, EF was unchanged. After intravenous drug administration, EF increased to 56.5% ± 9.7%). At 24 hours and 3 months after revascularization, EF became 59.5% ± 7.9% and 59.6% ± 8.2% in the urapidil-treated group, respectively, whereas EF in the placebo group did not change (50.4% ± 5.7% and 49.7% ± 4.9%, respectively). Revascularization did not acutely improve %Th. Intravenous urapidil improved %Th from 31.4% ± 17.6% to 44.2% ± 11.6%, whereas there was no change in the placebo group. At 3 months, %Th was 49.5% ± 12.9% in the urapidil-treated group and 39.7% ± 8.9% in the placebo group. Conclusions These data suggest that long-term α-adrenergic blockade might improve LVF at midterm after coronary revascularization. (Am Heart J 2004;147:e6.)