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Beta-blockade in ischaemic heart disease--influence of concomitant ISA or alpha-blockade on haemodynamic profile.
Postgrad Med J. 1983; 59 Suppl 3:45-52.PM

Abstract

To test the hypothesis that the depression of cardiac performance induced by competitive blockade of sympathetic stimulation at beta-adrenoceptors could be attenuated by the addition of a high level of intrinsic sympathomimetic activity (ISA) or concomitant alpha- and beta-blockade, the haemodynamic dose-response effects of propranolol (non-cardioselective, no ISA), pindolol (non-cardioselective, high ISA) and labetalol (non-cardioselective, alpha-blocker) were compared in a randomized study of 30 patients with stable coronary artery disease. Following 4 intravenous (i.v.) doses of each drug given according to a logarithmic cumulative dosage schedule, changes in circulatory variables were measured 2-4 min following each i.v. bolus and during bicycle exercise following the maximum dose of each drug. At rest propranolol induced dose-related reductions in heart rate, cardiac output and increases in pulmonary artery occluded pressure and systemic vascular resistance. The only change in resting haemodynamic variables following pindolol was a small dose-related increase in pulmonary artery occluded pressure. Labetalol induced dose-related falls in systemic blood pressure and vascular resistance with linear increase in cardiac output and pulmonary artery occluded pressure. During exercise the depression of cardiac output and increase in pulmonary artery occluded pressure which occurred in patients randomized to propranolol was effectively attenuated in the pindolol and labetalol groups. These observations on cardiac performance following beta-blockade in ischaemic heart disease suggest a rational basis for the use of compounds with added vasodilator or intrinsic sympathomimetic properties.

Authors

Silke B
No affiliation info available
Nelson GI
No affiliation info available
Ahuja RC
No affiliation info available
Taylor SH
No affiliation info available

MeSH

AdultClinical Trials as TopicCoronary DiseaseDose-Response Relationship, DrugEthanolaminesHemodynamicsHumansLabetalolMaleMiddle AgedPindololPropranololRandom Allocation

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

6359109

Citation

Silke, B, et al. "Beta-blockade in Ischaemic Heart Disease--influence of Concomitant ISA or Alpha-blockade On Haemodynamic Profile." Postgraduate Medical Journal, vol. 59 Suppl 3, 1983, pp. 45-52.
Silke B, Nelson GI, Ahuja RC, et al. Beta-blockade in ischaemic heart disease--influence of concomitant ISA or alpha-blockade on haemodynamic profile. Postgrad Med J. 1983;59 Suppl 3:45-52.
Silke, B., Nelson, G. I., Ahuja, R. C., & Taylor, S. H. (1983). Beta-blockade in ischaemic heart disease--influence of concomitant ISA or alpha-blockade on haemodynamic profile. Postgraduate Medical Journal, 59 Suppl 3, 45-52.
Silke B, et al. Beta-blockade in Ischaemic Heart Disease--influence of Concomitant ISA or Alpha-blockade On Haemodynamic Profile. Postgrad Med J. 1983;59 Suppl 3:45-52. PubMed PMID: 6359109.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Beta-blockade in ischaemic heart disease--influence of concomitant ISA or alpha-blockade on haemodynamic profile. AU - Silke,B, AU - Nelson,G I, AU - Ahuja,R C, AU - Taylor,S H, PY - 1983/1/1/pubmed PY - 1983/1/1/medline PY - 1983/1/1/entrez SP - 45 EP - 52 JF - Postgraduate medical journal JO - Postgrad Med J VL - 59 Suppl 3 N2 - To test the hypothesis that the depression of cardiac performance induced by competitive blockade of sympathetic stimulation at beta-adrenoceptors could be attenuated by the addition of a high level of intrinsic sympathomimetic activity (ISA) or concomitant alpha- and beta-blockade, the haemodynamic dose-response effects of propranolol (non-cardioselective, no ISA), pindolol (non-cardioselective, high ISA) and labetalol (non-cardioselective, alpha-blocker) were compared in a randomized study of 30 patients with stable coronary artery disease. Following 4 intravenous (i.v.) doses of each drug given according to a logarithmic cumulative dosage schedule, changes in circulatory variables were measured 2-4 min following each i.v. bolus and during bicycle exercise following the maximum dose of each drug. At rest propranolol induced dose-related reductions in heart rate, cardiac output and increases in pulmonary artery occluded pressure and systemic vascular resistance. The only change in resting haemodynamic variables following pindolol was a small dose-related increase in pulmonary artery occluded pressure. Labetalol induced dose-related falls in systemic blood pressure and vascular resistance with linear increase in cardiac output and pulmonary artery occluded pressure. During exercise the depression of cardiac output and increase in pulmonary artery occluded pressure which occurred in patients randomized to propranolol was effectively attenuated in the pindolol and labetalol groups. These observations on cardiac performance following beta-blockade in ischaemic heart disease suggest a rational basis for the use of compounds with added vasodilator or intrinsic sympathomimetic properties. SN - 0032-5473 UR - https://www.unboundmedicine.com/medline/citation/6359109/Beta_blockade_in_ischaemic_heart_disease__influence_of_concomitant_ISA_or_alpha_blockade_on_haemodynamic_profile_ L2 - https://www.diseaseinfosearch.org/result/130 DB - PRIME DP - Unbound Medicine ER -