Dose-Finding Study of Landiolol Hydrochloride: A Short-Acting β1-Blocker for Controlling Heart Rate During Coronary Computed-Tomography Angiography in JapanReport as inadecuate




Dose-Finding Study of Landiolol Hydrochloride: A Short-Acting β1-Blocker for Controlling Heart Rate During Coronary Computed-Tomography Angiography in Japan - Download this document for free, or read online. Document in PDF available to download.

Advances in Therapy

, Volume 30, Issue 9, pp 803–818

First Online: 24 September 2013Received: 06 August 2013DOI: 10.1007-s12325-013-0053-0

Cite this article as: Hirano, M., Hara, K., Ikari, Y. et al. Adv Ther 2013 30: 803. doi:10.1007-s12325-013-0053-0

Abstract

IntroductionCoronary computed-tomography angiography CCTA has high diagnostic performance, but it sometimes does not allow evaluation because of artifacts. Currently, the use of a β-blocker is recommended to prevent motion artifacts, but the β-blocker metoprolol, propranolol, etc. commonly used has a slow onset and long duration of action. Landiolol hydrochloride is an intravenous β1-blocker with a very short half-life. We investigated the efficacy and optimal dose of this drug for reduction of heart rate in patients undergoing CCTA.

MethodsEighty-seven subjects with ischemic heart disease were divided into three groups to receive landiolol hydrochloride at a dose of 0.125 Group L, 0.25 Group M, or 0.5 mg-kg Group H. CCTA was performed at 3–7 min after administration, and heart rate, blood pressure, and image quality were assessed.

ResultsHeart rate decreased rapidly after completion of landiolol hydrochloride administration in all groups, with a heart rate reduction of 15.55 ± 6.56% in Group L, 16.48 ± 7.80% in Group M, and 21.49 ± 6.13% in Group H Group L vs Group H, P = 0.0008; Group M vs Group H, P = 0.0109. Since there was no significant difference in heart rate during imaging among the three groups, although there was a significant difference between groups L and H and groups M and H in terms of percent change in heart rate, coronary stenosis was diagnosable in all groups with no significant difference.

ConclusionLandiolol hydrochloride showed a rapid onset and short β-blocking effect, and was most effective at a dose of 0.5 mg-kg. However, the diagnosable proportion had no significant differences among the three groups in CCTA. Therefore, the clinically recommended dose was 0.125 mg-kg or less, considering the heart rate of patients with suspected coronary stenosis during CCTA.

KeywordsAngiography β-blocker Cardiology Coronary computed-tomography angiography CCTA Image quality Landiolol hydrochloride Motion artifact Multidetector row computed tomography MDCT ClinicalTrials.gov Identifier: NCT00311038.

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Author: Masaharu Hirano - Kazuhiro Hara - Yuji Ikari - Masahiro Jinzaki - Misako Iino - Chikuma Hamada - Sachio Kuribayashi

Source: https://link.springer.com/







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