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[Cardioselective beta receptor blockade in acute myocardial infarct with talinolol]
Insights
Talinolol (Cordanum) administration in acute myocardial infarction patients reduced heart rate and blood pressure, aiding heart recovery. It also favorably impacted cardiac dysrhythmias, contrasting with the control group
Area of Science:
- Cardiology
- Pharmacology
Background:
- Acute myocardial infarction (AMI) is a leading cause of cardiovascular mortality.
- Beta-receptor blockers are crucial in managing AMI, particularly in the early phase.
- Understanding the hemodynamic effects of specific beta-blockers like talinolol is essential for optimizing treatment strategies.
Purpose of the Study:
- To investigate the influence of talinolol (Cordanum) on hemodynamic parameters in patients with acute myocardial infarction.
- To evaluate the efficacy of talinolol in managing cardiac dysrhythmias during AMI.
- To compare the effects of talinolol with conventional treatment in a control group.
Main Methods:
- Intravenous and oral administration of talinolol in 9 patients with AMI.
- Monitoring of hemodynamic parameters including heart rate, arterial blood pressure, cardiac output, and left-ventricular filling pressure.
- Comparison with a control group (n=11) receiving conventional treatment.
- Assessment of cardiac dysrhythmias, including supraventricular and ventricular arrhythmias, and conduction disturbances.
Main Results:
- Talinolol caused a slight decrease in heart rate, arterial blood pressure, and cardiac output, with a more distinct reduction in contractility.
- Left-ventricular filling pressure remained largely uninfluenced.
- Compared to the control group, talinolol showed a more pronounced decrease in heart rate and contractility, suggesting a 'heart exoneration' effect.
- Talinolol administration was associated with a favorable influence on supraventricular and ventricular cardiac dysrhythmias, with no instances of ventricular fibrillation or AV conduction disturbances observed, unlike in the control group.
- One patient experienced a possible deterioration of pumping function, and another a potential sinus node depressive effect.
Conclusions:
- Talinolol demonstrates beneficial hemodynamic effects in acute myocardial infarction, contributing to heart unloading and improved rhythm control.
- Its anti-arrhythmic properties are significant, offering an advantage over conventional treatment in preventing serious rhythm disturbances.
- Beta-receptor blockers, including talinolol, are indicated in the early phase of AMI, provided contraindications like shock or severe heart insufficiency are absent, to potentially limit infarct expansion.
Abstract:
On 9 patients with acute myocardial infarction the influence of talinolol (cordanum) on haemodynamic parameters in intravenous administration and after this in oral application was examined. Talinolol led to a slight decrease of the heart rate, of the arterial blood pressure and of the cardiac output as well as to a more distinct reduction of the contractility in nearly uninfluenced left-ventricular filling pressure. In comparison to a conventionally treated control group (n = 11) the decrease of the heart rate as well as of the contractility was somewhat more distinct. The changes found are to be explained in the sense of a heart exoneration. In one patient possibly by talinolol a deterioration of the pumping function developed 56 hours after the acute event. In another patient a depressive effect on the sinus node is not to be excluded. Ventricular fibrillation and disturbances of the atrioventricular conduction did not appear in contrast to the control group. The influence on supraventricular and ventricular cardiac dysrhythmias was distinctly favourable in other 9 patients with acute myocardial infarction despite clinical signs of cardiac decompensation. Only in one patient a further deterioration of the pumping function developed despite control of the disturbance of rhythm. According to the experimental and up to now existing clinical experiences beta-receptor blockers are indicated above all in the early phase of the acute myocardial infarction, if shock, acute heart insufficiency and bradycardiac disturbances of the heart rhythm are not existing. Here paticularly at the beginning of the therapy is a proved change in the first 2-4(-8) hours to prevent the expansion of the infarct size or the onset of large infarctions.