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ß-Adrenergic Blockade and Myocardial Perfusion in Coronary Artery Disease: Differential Effects in Stenotic Versus Remote Myocardial Segments

Pascal Koepfli, MD1, Christophe A. Wyss, MD1, Mehdi Namdar, MD1, Michael Klainguti, MD1, Gustav K. von Schulthess, MD, PhD2, Thomas F. Lüscher, MD3 and Philipp A. Kaufmann, MD1

1 Nuclear Cardiology Section, University Hospital, Zurich, Switzerland
2 Department of Nuclear Medicine, University Hospital, Zurich, Switzerland
3 Division of Cardiology, University Hospital, Zurich, Switzerland



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  		FIGURE 1. Treatment-induced changes in resting MBF. Resting MBF decreased in both treatment groups in remote segments. In stenotic segments, however, metoprolol decreased MBF (–10%, P < 0.05) whereas carvedilol did not (–1%, NS), improving the oxygen consumption/supply balance.

 


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  		FIGURE 2. Effect of treatment on hyperemic MBF. In both groups, hyperemic MBF was significantly lower in stenotic segments than in remote segments before treatment. This difference disappeared after treatment with either drug.

 


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  		FIGURE 3. Treatment-induced changes in CFR. Pooled data of both groups showed that regional CFR increased significantly in stenosis-dependent segments, rather than in remote segments.

 


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  		FIGURE 4. Relationship between lesion severity and CFR. CFR was lowest in the most severe stenosis but increased significantly after treatment.

 




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