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Stress/catecholamine-induced cardiac necrosis. Reduction by beta 1-selective blockade.

J M Cruickshank1, G Neil-Dwyer, Y Hayes

  • 1ICI Pharmaceuticals PLC, Macclesfield, England.

Postgraduate Medicine
|February 29, 1988
PubMed
Summary

Severe head injury can cause cardiac issues due to high catecholamines. Atenolol, a beta-blocker, significantly reduced cardiac damage and elevated cardiac enzyme levels in patients with severe head injury.

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Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Severe head injury induces a hyperadrenergic state, increasing cardiac morbidity risk.
  • Previous studies confirmed cardiac complications in patients with severe head injury.

Purpose of the Study:

  • To investigate the relationship between plasma catecholamine levels and cardiac morbidity in severe head injury patients.
  • To evaluate the efficacy of atenolol in mitigating catecholamine-induced cardiac damage.

Main Methods:

  • 114 hemodynamically stable acute head injury patients were randomized to placebo or atenolol.
  • Atenolol was administered intravenously then orally for seven days.
  • Plasma catecholamine levels and cardiac-specific isoenzyme CK-MB were monitored.

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Main Results:

  • A significant positive correlation between norepinephrine and CK-MB was observed in the placebo group (P<0.01).
  • Elevated CK-MB levels (compatible with myocardial infarction) occurred in 30% of the placebo group versus 7.4% in the atenolol group (P<0.05).
  • Atenolol reduced supraventricular tachycardia, ECG changes, and prevented cardiac necrosis.

Conclusions:

  • Beta-1 selective blockade with atenolol significantly inhibits catecholamine-induced cardiac necrosis.
  • Atenolol demonstrates potential clinical benefits in managing cardiac complications associated with severe head injury.