Hemodynamic effects of propranolol in coronary heart disease

Parker, John O.; West, Roxroy O.; Giorgi, Salvatore Di

doi:10.1016/0002-9149(68)90007-6

Cited by 114 publications

(19 citation statements)

References 15 publications

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“…Between atenolol and NTG, the heart rate (P < 0.01), stroke length (P < 0.05), diastolic and mean BP (P < 0.01) and vascular resistance effects (P < 0.05) were different. 13.0 ± 0.4 13.0 ± 0.4 12.6 ± 0.4 (cm) Atenolol 12.2 ± 0.8 12.1 ± 0.8 11.6 ± 0.7 Buccal NTG 11.1 ± 0.7 9.8 ± 0.6** 9.5 ± 0. decreased and the systemic vascular resistance increased as commonly reported following acute P-adrenoceptor blockade (Hendry et al, 1981;Parker et al, 1968;Taylor et al, 1982). The actions of nitrates have been widely investigated in ischaemic heart disease.…”

Section: Difference Between Drugs and Placebomentioning

confidence: 85%

Pharmacodynamic monitoring during acute intervention in ischaemic heart disease using a new echo‐Doppler device.

Silke

Verma

1990

Brit J Clinical Pharma

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Infirmary at Leeds, Leeds 1 We have utilised a new non-imaging echo-Doppler cardiac output device, using the principle of attenuated compensated volume flow (ACVF), to assess the cardiovascular effects of atenolol and buccal nitroglycerine (NTG) in a placebo-controlled study of 30 patients with coronary disease. 2 Atenolol (4 mg i.v.) reduced heart rate, cardiac output and time-averaged mean aortic velocity (P < 0.01) and increased systemic vascular resistance (P < 0.01). 3 Buccal NTG (5 mg) reduced systemic mean arterial pressure (P < 0.01), cardiac stroke volume (P < 0.05) and stroke length (P < 0.01). 4 Thus although both drugs reduced time-averaged aortic velocity (an index of cardiac performance), the concomitant reduction in cardiac stroke length and tachycardia suggested sub-optimal cardiac filling for buccal NTG, whereas for atenolol (with the associated increased systemic vascular resistance but unchanged stroke length) attenuation of sympathetic stimulation at cardiac P-adrenoceptors.S The ACVF method of cardiovascular monitoring should prove useful in human pharmacodynamic studies.

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Section: Difference Between Drugs and Placebomentioning

confidence: 85%

Pharmacodynamic monitoring during acute intervention in ischaemic heart disease using a new echo‐Doppler device.

Silke

Verma

1990

Brit J Clinical Pharma

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“…Average relative body weight and skin folds in Japanese are 1520% and 35-60%, respectively, less than those of Americans (6). This explains why the dose of propranolol administered in this study was less than that used by other investigators (7)(8)(9)(10). Approximately within 5 min of drug administration, the patients performed a second supine leg exercise test at the same work load.…”

Section: Methodsmentioning

confidence: 93%

Effects of adalat (nifedipine) on left ventricular hemodynamics in angina pectoris: Comparative study with propranolol

Kurita

Ogawa

Kanazawa

et al. 1976

Cathet. Cardiovasc. Diagn.

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The hemodynamic effects of nifedipine and propranolol administered intravenously were studied in 17 patients with angina pectoris. Nine patients received nifedipine and eight received propranolol. The hemodynamic parameters were compared at rest and during supine bicycle exercise at work loads known to produce angina. Exercise-induced angina improved in four out of nine patients following nifedipine and in one out of eight patients following propranolol. Nifedipine significantly reduced the increment of left ventricular end-diastolic pressure and Vmax during exercise. Intravenous propranolol significantly suppressed the increment of heart rate, max dp/dt, tension time index, and Vmax during exercise. Although the exact mode of action of nifedipine remains uncertain, it is suggested that it decreases myocardial oxygen requirements primarily through a reduction of left ventricular volume, whereas propranolol suppresses the positive chronotropic and inotropic responses of the heart muscle to exercise.

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“…The decrease in heart rate and contractility by propranolol would tend to decrease myocardial oxygen consumption, while the ability of propranolol to increase preload, i.e. LV filling pressure (Parker et al, 1968), will tend to increase oxygen consumption. The net effect, therefore, is a balance between these actions variably to decrease or to increase myocardial oxygen consumption.…”

Section: Discussionmentioning

confidence: 99%

Celiprolol: a positive inotropic β‐adrenoceptor blocking agent in conscious dogs

Nganele¹,

DeLeonardis²,

Hintze³

1988

British J Pharmacology

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3 Intravenous injection of celiprolol (3 mgkg-') in nine dogs, increased LV dP/dt by 13 + 2.6%, velocity of shortening (LV dD/dt) by 9.2 + 3.4%, and heart rate by 19 + 4.6% and decreased LV end-diastolic diameter by 1.8 + 0.8%, all significantly (P < 0.05). Celiprolol blocked the inotropic actions of isoprenaline (0.5 ygkg-') but only partially reduced its hypotensive effects. Propranolol, in contrast, reduced LV dP/dt by 17 + 3.3% and heart rate by 8.1 + 2.7% (P < 0.05) while totally abolishing the hypotension, tachycardia and increase in LV dP/dt caused by isoprenaline. Following fi-adrenoceptor blockade with propranolol and with heart rate held constant by electrical pacing, celiprolol increased LV dP/dt by 16 + 4.0%, LV dD/dt by 12 + 3.0% and reduced LV end-diastolic diameter by 3.5 + 0.5% (P < 0.05). 4 Thus, in conscious dogs, celiprolol increases inotropic state and reduces preload independently of fl-adrenoceptor mechanisms and the Bowditch phenomenon, while effectively blocking fil-receptors in the heart. These properties would make celiprolol useful in patients where a conventional f-adrenoceptor blocking agent might lead to pump failure.

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Hemodynamic effects of propranolol in coronary heart disease

Cited by 114 publications

References 15 publications

Pharmacodynamic monitoring during acute intervention in ischaemic heart disease using a new echo‐Doppler device.

Pharmacodynamic monitoring during acute intervention in ischaemic heart disease using a new echo‐Doppler device.

Effects of adalat (nifedipine) on left ventricular hemodynamics in angina pectoris: Comparative study with propranolol

Celiprolol: a positive inotropic β‐adrenoceptor blocking agent in conscious dogs

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