Cardiorespiratory and symptomatic variables during maximal and submaximal exercise in men with stable effort angina: a comparison of atenolol and celiprolol

Celiprolol is a novel beta1 selective adrenoreceptor blocker with partial beta2 agonism and direct vasodilator activity. These ancillary properties may reduce symptomatic breathlessness and fatigue and modify respiration during exercise. To test this hypothesis 20 men with stable effort angina were enrolled in a double-blind crossover study to investigate the effects of atenolol 100 mg once daily (A) and celiprolol 400 mg once daily (C) on cardiorespiratory and symptomatic variables during maximal and submaximal exercise. Total exercise time on a modified Bruce protocol was similar on both treatments: C 12.5 min, A 13.1 min. During steady state submaximal exercise at 60.75% (mean 68%) of maximum work capacity, minute ventilation (C 33.81 min−1, A 33.51 min−1), oxygen uptake (C 14.6 ml.kg−1. min−1, A 151 ml. kg−1. min−1), respiratory exchange ratio (C0.89, A 0.87), ratio of VEI VCO2 (C33.6, A 33.4), ratio of VEIVO2 (C2.34, A 2.72), Borg perceived exertion score (C 11.2, A 10.9) and visual analogue scores for breathlessness (C 29.5, A 25.9) and muscle fatigue (C 28.9, A 26.0) were all similar on both treatments. At maximal exercise capacity on the modified Bruce protocol, minute ventilation (C 58.31 min−1, A 60.41 min−1), oxygen uptake (C 21.3 ml. kg−1. min−1, A 21.7ml. kg−1.min−1), respiratory exchange ratio (C 1.02, A.1.05), ratio VEIVCO2 (C 34.8, A 35.9), and ratio VEIVO2 (C2.80, A 2.83) were also similar on both drugs. Over a 10 day period anginal attacks (C 10.1 ± 10.4, A 5.4 ± 5.9) and sublingual GTN use (C 5.9 ± 10.3, A 4.4 ± 9.8) were both more frequent on celiprolol. We conclude, that in comparison with atenolol, celiprolol did not modify respiration during either steady state submaximal or maximal exercise and did not alleviate symptomatic breathlessness and fatigue. However, symptomatic ischaemia was more frequent with celiprolol