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Haemodynamic effects of atenolol in patients with coronary artery disease
Insights
Atenolol, a cardioselective beta-blocker, reduced heart rate and cardiac output in coronary artery disease patients. Its effects on stroke volume and left ventricular function suggest potential benefits for angina pectoris treatment.
Area of Science:
- Cardiology
- Pharmacology
- Cardiovascular Physiology
Background:
- Coronary artery disease (CAD) poses significant cardiovascular challenges.
- Understanding the haemodynamic effects of novel beta-blocking agents is crucial for treatment optimization.
Purpose of the Study:
- To investigate the haemodynamic effects of atenolol, a cardioselective beta-blocker, in patients with coronary artery disease.
- To compare the haemodynamic profile of atenolol with other beta-blockers like propranolol and practolol.
Main Methods:
- Intravenous administration of atenolol in cumulative doses (0.03, 0.06, 0.12 mg/kg) to 8 patients with CAD at rest.
- Monitoring of heart rate, cardiac output, stroke volume, left ventricular dP/dt max, left ventricular filling pressure, mean aortic pressure, and total peripheral resistance.
- Utilized atrial pacing to differentiate rate-dependent from independent effects on stroke volume.
Main Results:
- Atenolol significantly decreased heart rate and cardiac output in a dose-dependent manner.
- Stroke volume fell significantly, independent of heart rate changes, indicating a direct myocardial effect.
- Left ventricular dP/dt max was significantly reduced, while filling pressures and mean aortic pressure remained unchanged.
- Total peripheral resistance increased post-atenolol administration.
Conclusions:
- Atenolol exhibits haemodynamic effects characterized by reduced cardiac output and contractility, with increased peripheral resistance.
- These effects are comparable to propranolol, suggesting a potent beta-blocking action.
- Atenolol's profile indicates potential efficacy in managing patients suffering from angina pectoris.
Abstract:
The haemodynamic effects of atenolol, a new cardioselective beta-blocking agent, have been studied at rest in 8 patients with coronary artery disease. The drug was administered intravenously in cumulative doses of 0.03, 0.06, and 0.12 mg/kg body weight. A significant decrease in heart rate was associated with a fall in cardiac output. However, this cardiac output fall was not entiely rate dependent, since stroke volume fell significantly both during spontaneous sinus rhythm and when heart rate was maintained constant by atrial pacing. A dose related and significant reduction occurred in left ventricular dP/dt max without significant change in left ventricular filling pressure or mean aortic pressure. Total peripheral resistance at rest rose after atenolol. The haemodynamic findings more closely resemble those which follow intravenous propranolol than those after intravenous practolol in a similar group of patients. These actions of atenolol suggest that it may be a useful agent in the treatment of patients with angina pectoris.