Hemodynamic effects of a beta adrenergic blocking agent : atenolol in patients with severe mitral stenosis

The hemodynamic effects of atenolol, a cardioselective adrenergic blocking drug, were studied in 10 patients with clinically severe mitral stenosis during cardiac catheterization to evaluate the severity of disease before cardiac surgery. At 5 minutes after intravenous injection of 0.1 mg/kg of atenolol, there were significant reductions of heart rate, cardiac index, pulmonary pressure, pulmonary capillary wedge pressure and mitral valve gradient. The right and left ventricular filling pressures were increased slightly. The pulmonary and systemic vascular resistance did not change after atenolol. The PR interval although prolonged significantly was still within normal range. No serious side effects occurred during the post-catheterization 24 hour observation period except for one patient who developed slow ventricular rate (48/min) during the study. The hemodynamic effects of atenolol observed in this study appear to benefit the patients with mitral stenosis by reduction of pulmonary pressure, pulmonary capillary wedge pressure and mitral valve gradient. These hemodynamic changes may, therefore, lead to improvement of pulmonary congestive symptoms.