Dose-Finding study of landiolol hydrochloride: A short-acting Β1-Blocker for controlling heart rate during coronary computed-Tomography angiography in japan

Masaharu Hirano, Kazuhiro Hara, Yuji Ikari, Masahiro Jinzaki, Misako Iino, Chikuma Hamada, Sachio Kuribayashi

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3 Citations (Scopus)

Abstract

Introduction: Coronary computedtomography 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 b-blocker (metoprolol, propranolol, etc.) commonly used has a slow onset and long duration of action. andiolol hydrochloride is an intravenous β 1-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. Methods: Eighty-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. Results: Heart 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. Conclusion: Landiolol hydrochloride showed a rapid onset and short b-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.

Original languageEnglish
Pages (from-to)803-818
Number of pages16
JournalAdvances in Therapy
Volume30
Issue number9
DOIs
Publication statusPublished - 2013 Sep

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Keywords

  • Β-Blocker
  • Angiography
  • Cardiology
  • CCTA
  • Coronary computed-tomography angiography
  • Image quality
  • Landiolol hydrochloride
  • MDCT
  • Motion artifact
  • Multidetector row computed tomography

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)

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