Propranolol during the evolution and subsequent ten days of myocardial infarction in man: Hemodynamic, initial cardiac energetic, and neurohumoral responses

I. S. Mueller, P. S. Rao, James Fletcher, R. Evans, F. Hertelendy, L. Stickley, K. Walter

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

During the evolution of transmural myocardial infarction an intensive sympathetic hyperactivity was observed. Plasma l-norepinephrine and epinephrine contents were strikingly increased, the mean values to 2.04±1.10 (SD) and 0.94±0.48μg.l, respectively. Propranolol (0.1 mg/kg) was administered intravenously within an average of 8.8h of transmural myocardial infarction to 55 patients who did not show significant left ventricular failure. The drug was continued orally with an average dose of 56±20(SD) mg q6h for 10 d. Mean plasma propranolol levels during the first 5 d ranged between 89 and 162 ng/ml. Cardiac index, left ventricular ejection fraction, and, to a lesser degree, blood pressure significantly decreased. Mean pulmonary capillary wedge pressure remained unchanged. Decreases in coronary blood flow and myocardial oxygen consumption were associated with improvement of myocardial lactate metabolism, suggesting reduced myocardial oxygen requirements. Plasma free fatty acid contents significantly decreased. Myocardial glucose extraction and respiratory quotient increased, indicating enhanced carbohydrate utilization. Prior to propranolol administration, plasma glucose and glucagon contents were increased and plasma insulin levels were inappropriately low. Initial glucagon and initial l-norepinephrine and epinephrine contents were correlated (r=0.54 and 0.50, p

Original languageEnglish (US)
Pages (from-to)393-403
Number of pages11
JournalClinical Cardiology
Volume2
Issue number6
StatePublished - 1979
Externally publishedYes

Fingerprint

Propranolol
Hemodynamics
Myocardial Infarction
Glucagon
Epinephrine
Norepinephrine
Glucose
Pulmonary Wedge Pressure
Nonesterified Fatty Acids
Oxygen Consumption
Stroke Volume
Lactic Acid
Carbohydrates
Insulin
Oxygen
Blood Pressure
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Propranolol during the evolution and subsequent ten days of myocardial infarction in man : Hemodynamic, initial cardiac energetic, and neurohumoral responses. / Mueller, I. S.; Rao, P. S.; Fletcher, James; Evans, R.; Hertelendy, F.; Stickley, L.; Walter, K.

In: Clinical Cardiology, Vol. 2, No. 6, 1979, p. 393-403.

Research output: Contribution to journalArticle

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