Abstract
Background: Acute haemodynamic effects of beta blockade on RV function in pulmonary arterial hypertension (PAH) is unclear.
Aim: To assess the RV response to beta blockade in pulmonary arterial hypertension (PAH) during rest and exercise.
Methods: In an experimental study, effects of fixed-dose Esmolol infusion were evaluated in a 2-week old monocrotaline (MCT) PAH rodent model using CMR-measured intracardiac volumes. Subsequently, 8 patients with idiopathic PAH underwent RV pressure-volume catheterisation at rest and during exercise. Following baseline measurements, Esmolol was infused at two doses during steady-state supine exercise.
Results: In the MCT model, Esmolol reduced heart rate and increased RV stroke volume (SV) mediated by increased EDV compared to controls (p<0.019). In IPAH, supine exercise increased RV EDP with reduction in EDV and ESV despite increases in HR and contractility. At matched workloads (25W), Esmolol attenuated the increase in exercise HR, reversing the exercise-associated increase in EDP (p<0.01) in a dose response relationship. Esmolol improved RV stroke work to cardiac output ratio without affecting RV afterload (Ea) or systemic vascular resistance.
Conclusions: Esmolol improves RV diastolic filling in PAH at rest and during low-grade exercise, preserving SV and CO, with energetically favourable effects on contractile efficiency.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 1844.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2022
