Abstract

Hemodynamic response to exercise before and 10 minutes after propranolol (5 mgintravenously) was studied in 10 young patients with pure mitral stenosis who had normal sinus rhythm and no cardiac failure. After propranolol the mean heart rate and cardiac index at rest were lower than during the control state (respectively, 95 +- 4 versus 82 +- 3 beatsmin, 3.4 +- 0.2 versus 2.8 +0.1 litersmin per m2). As a result, the mean pulmonary wedge pressure and mean mitral valve gradient at rest were lower (respectively, 22 +- 2 versus 18 +- 2 mm Hg, 24 +- 2 versus 17 +- mm Hg). During exercise after propranolol the values of pulmonary wedge pressure and mitral valve gradient were lowerthan control values during exercise (respectively, 39 +- 3 versus 30 +- 2 mmHg, 44 +- 3 versus 32 +- 3 mm Hg), again because of the lower heart rate andcardiac index (130 +- 6 versus 104 +- 6 beatsmin, 4.6 +- 3 versus 3.7 +2 litersmin per m2). Left ventricular end-diastolic pressure and stroke indexshowed no significant changes. Thus propranolol may benefit patients with puremitral stenosis with sinus rhythm and no cardiac failure whose symptoms occur during those reversible conditions characterized by an increase in heartrate or cardiac output, or both. Verf.-Referat