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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
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.
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.
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.