The effects of 5 and 10 mg bisoprolol once daily for 7 days on exercise ECG, myocardial perfusion and left ventricular function in 25 patients with stable coronary heart disease have been assessed in a double-blind, randomized, parallel group trial design. ST-segment depression during exercise was reduced by 56% by 5 mg bisoprolol and by 64% after 10 mg; the difference between the dose levels was significant. Heart rate, systolic and diastolic blood pressure and the rate-pressure product were reduced to similar extent both at rest and during exercise by both doses. Left ventricular thallium-201 scintigrams indicated a significant reduction in myocardial perfusion defects after 10 mg bisoprolol compared to baseline; however, the difference between the two active treatments was not significant. Left atrial and left ventricular diameters obtained by one-dimensional echocardiography, and the calculated shortening fraction, remained unchanged after bisoprolol, and so gave no evidence of a negative inotropic action. It is concluded that 5 mg bisoprolol was effective in once-a-day treatment of angina pectoris due to coronary heart disease, and a further improvement can be expected on increasing the dose to 10 mg.
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