Does the β-blocker nebivolol increase coronary flow reserve?

• Published in: Cardiovascular drugs and therapy 2007-04, Vol.21 (2), p.99-108
• Main Authors: TOGNI, Mario, VIGORITO, Francesco, WINDECKER, Stephan, ABRECHT, Linda, WENAWESER, Peter, COOK, Stephane, BILLINGER, Michael, MEIER, Bernhard, HESS, Otto M
• Format: Article
• Language: English
• Subjects: Adenosine; Adrenergic beta-Antagonists - administration & dosage; Adrenergic beta-Antagonists - pharmacology; Adrenergic receptors; Angioplasty, Balloon, Coronary; Benzopyrans - administration & dosage; Benzopyrans - pharmacology; Beta blockers; Biological and medical sciences; Blood Flow Velocity - drug effects; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular system; Collateral Circulation - drug effects; Coronary artery; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; Coronary Artery Disease - therapy; Coronary heart disease; Echocardiography, Doppler; Ethanolamines - administration & dosage; Ethanolamines - pharmacology; Female; Flow velocity; Heart; Heart diseases; Heart rate; Humans; Hyperemia; Infusions, Intra-Arterial; Male; Medical sciences; Middle Aged; Nebivolol; Nitric oxide; Oxygen consumption; Perfusion; Pharmacology. Drug treatments; Receptors (physiology); Reduction; Stenosis; Vascular Resistance - drug effects; Vasodilator Agents - administration & dosage; Vasodilator Agents - pharmacology; Velocity
• ISSN: 0920-3206; 1573-7241
• DOI: 10.1007/s10557-006-0494-7

Nebivolol, a highly selective beta1-adrenergic receptor-blocker, increases basal and stimulated endothelial nitric oxide (NO)-release. It is unknown, whether coronary perfusion is improved by the increase in NO availability. Therefore, we sought to evaluate the effect of nebivolol on coronary flow reserve (CFR) and collateral flow. Doppler-flow wire derived coronary flow velocity measurements were obtained in ten controls and eight patients with coronary artery disease (CAD) at rest and after intracoronary nebivolol. CFR was defined as maximal flow during adenosine-induced hyperemia divided by resting flow. In the CAD group, collateral flow was determined after dilatation of a flow-limiting coronary stenosis. Collateral flow index (CFI) was defined as the ratio of flow velocity during balloon inflation divided by resting flow. CFR at rest was 3.0+/-0.6 in controls and 2.1+/-0.4 in CAD patients. After intracoronary doses of 0.1, 0.25, and 0.5 mg nebivolol, CFR increased to 3.4+/-0.7, 3.9+/-0.9, and 4.0+/-0.1 (p