There is accumulating evidence that β blockers improve symptoms and prognosis in patients with ischaemic heart disease (IHD).1 Impaired filling of the left ventricle is often found in association with IHD.2 Improvement in diastolic left ventricular function may be an important mechanism of action of β blockers. This study investigated the effect of β adrenergic blockade on diastolic filling in patients with IHD.

We carried out a retrospective analysis of left ventricular filling in 265 consecutive patients attending our department for routine clinical evaluation of chest pain. All patients underwent our standard imaging protocol of thallium-201 myocardial perfusion imaging and list mode radionuclide ventriculography (RNVG). Left ventricular filling was assessed using RNVG, which has been previously validated for the assessment of cardiac diastolic function.3 4 It has also been extensively used in the assessment of left ventricular filling in various conditions.4

Background corrected left ventricular activity–time curves were generated using a fixed left ventricular and background region of interest. Left ventricular ejection fraction (LVEF) was calculated in the usual manner. The normal lower limit of LVEF with this technique is 40% in our institution. The percentage of left ventricular filling …