Hemodynamic Effect of a Combined Therapy with Propranolol and Digoxin

Gebhardt, W; Blümchen, G

doi:10.1159/000166118

Cited by 12 publications

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“…Auch in hämodynamischen (4,10,13,14,38) sowie ballistokardiographischen Untersuchungen (33,42) konnte durch einmalige Digitalisgabe eine Besserung der nach (3-Blockern aufgetretenen Kontraktilitätsminderung auch bei gesunden Probanden erreicht werden.…”

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“…Auch bei nicht-invasiven ballistokardiographischen Untersuchungen (33, 42) an Gesunden sowie invasivhämodynamischen Untersuchungen wird eine Kompensierung der negativ-inotropen Wirkung der (3-Blocker durch Digitalis beobachtet. So wurde bei herzgesunden Probanden eine Normalisierung des Belastungsvenendruckes, der Zirkulationszeit und der Herzgröße nach Digitalis erreicht (13,14). Nechwatal und Mitarbeiter (38) (3-Blocker vermindern die chronotrope und inotrope Wirkung kardialer sympathischer Nerven wie auch zirkulierender (3-Sympathikomimetika.…”

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Einfluß von Digitalis auf die Pindolol-Wirkung bei Koronarkranken mit Belastungsherzinsuffizienz

Oeff¹,

Beck²,

Hochrein³

1979

Dtsch med Wochenschr

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The activity of the beta-receptor blocker pindolol (0.4 mg i.v.) was investigated alone and in combination with digitalis (moderately fast loading) in 12 patients with coronary heart disease and without manifest signs of cardiac insufficiency. These patients showed pathological increase of left ventricular filling pressure during exercise testing. The exercise-induced rise of the mean pulmonary arterial and capillary pressures were increased by pindolol. Concurrently the increase of cardiac frequency was clearly diminished during ergometry (from 107/min without pindolol to 96/min, P less than 0.005). Digoxin given orally for an average of 5 days prevented the pressure increase in the pulmonary circulation induced by pindolol during exercise testing and at rest. The frequency reducing effect of pindolol was potentiated by digitalis. Use of digitalis alone did not influence mean exercise-induced pressure increase of the pulmonary circulation. In fact in some cases deterioration of these parameters was observed.

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Einfluß von Digitalis auf die Pindolol-Wirkung bei Koronarkranken mit Belastungsherzinsuffizienz

Oeff¹,

Beck²,

Hochrein³

1979

Dtsch med Wochenschr

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“…But there is now also substantial evidence that B-blocking agents can have adverse effects, most of them directly related to the pharmacological action of the substances. Haemodynamic studies have clearly shown that, even in normal man, cardiac output and cardiac work are reduced at rest and during work by B-receptor blockade (6,12,13,23). This reduction of cardiac work, caused by the negative inotropic and chronotropic properties of the Bblockers, seems to be the mechanism for their therapeutic effect in cases of anginal pain.…”

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Haemodynamic Effects of Β‐receptor Blocking Agents and Digitalis in Ischaemic Coronary Heart Disease With Angina Pectoris

Dunér

Pernow

1973

Journal of Internal Medicine

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Abstract. The haemodynamic effects of β‐receptor blocking agents (propranolol and pindolol) alone and in combination with digitalis have been studied at rest and during exercise in 20 patients with coronary heart disease and angina pectoris. Right heart catheterization was performed and cardiac output was determined by the indicator‐dilution technique. β‐blockade induced at rest a significant fall in heart rate, all other variables studied being fairly unchanged. During exercise the cardiac output and stroke volume were lower than before β‐blockade, while the BP in the right ventricle, pulmonary artery and pulmonary wedged position rose. Propranolol gave a slightly greater increase in pulmonary artery wedged pressure compared to pindolol, but no significant differences concerning the other variables studied. After administration of digitalis together with a β‐blocking agent the systolic and end‐diastolic pressures of the right ventricle as well as the pulmonary artery wedged pressure during exercise were significantly lower than after β‐blockade alone. Cardiac output, stroke volume and calculated left ventricular work index were all significantly higher, while the product of heart rate and systolic BP was unchanged. These findings indicate that digitalis eliminates the negative inotropic effect of a β‐blocking agent but leaves the negative chronotropic effect unchanged. It is suggested that, when a β‐blocking agent is used in the treatment of angina pectoris, digitalization seems to be indicated when cardiac failure is likely to appear.

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Digitalis

Schüren¹

1984

Koronarerkrankungen

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Hemodynamic Effect of a Combined Therapy with Propranolol and Digoxin

Cited by 12 publications

References 1 publication

Einfluß von Digitalis auf die Pindolol-Wirkung bei Koronarkranken mit Belastungsherzinsuffizienz

Einfluß von Digitalis auf die Pindolol-Wirkung bei Koronarkranken mit Belastungsherzinsuffizienz

Haemodynamic Effects of Β‐receptor Blocking Agents and Digitalis in Ischaemic Coronary Heart Disease With Angina Pectoris

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