Effect of acebutolol on left ventricular performance

The effect of acebutolol on left ventricular performance was examined by various noninvasive means in three studies. M-mode echocardiographic measurements were made in 21 patients with coronary artery disease who were receiving placebo, acebutolol, and propranolol in a double-blind, randomized, crossover study. In these patients with normal or near-normal resting left ventricular function, neither drug induced depression of left ventricular function. In 26 patients with chronic angina pectoris receiving acebutolol under double-blind, placebo-controlled conditions, gated (equilibrium) myocardial blood pool imaging using red blood cells labeled with technetium 99m showed acebutolol to have no clinically significant negative effect on left ventricular performance at rest or during supine bicycle exercise. Acebutolol at effective antianginal doses modestly improved resting global and regional myocardial function. In 13 patients with stable angina pectoris, single-pass studies of left ventricular function with indium 113 under double-blind, placebo-controlled conditions similarly showed acebutolol to have no clinically significant negative inotropic effects. In conclusion, acebutolol is safe for use in patients with coronary disease and a wide range of ejection fractions but, as with all beta blockers, should be used cautiously in patients with markedly reduced resting left ventricular function.