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Nonselective beta-receptor stimulation and blockade and left ventricular function.

F H Leenen, D L Smith, L DeLeve

    Clinical Pharmacology and Therapeutics
    |November 1, 1983
    PubMed
    Summary
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    Isoproterenol increased left ventricular (LV) size, while propranolol decreased it, impacting cardiac output through direct cardiac actions and venous return. Beta-receptor stimulation and blockade influence heart function.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Physiology

    Background:

    • Understanding the direct cardiac effects of beta-adrenergic agents is crucial for managing cardiovascular function.
    • Isoproterenol and propranolol are key drugs affecting heart rate and contractility via beta-receptors.

    Purpose of the Study:

    • To assess the impact of increasing intravenous isoproterenol doses on left ventricular (LV) dimensions and function.
    • To evaluate the effects of oral propranolol on LV size and function in the presence of isoproterenol.

    Main Methods:

    • M-mode echocardiography was used to study 11 healthy subjects.
    • Isoproterenol was administered intravenously until heart rate increased by 25-30 bpm.
    • Echocardiographic measurements of LV end-diastolic and end-systolic dimensions were recorded before and after propranolol administration.

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    Main Results:

    • Isoproterenol increased LV end-diastolic dimension (LVED) despite associated tachycardia.
    • Propranolol decreased LVED, even with its negative inotropic and chronotropic effects.
    • Isoproterenol reduced LV end-systolic dimension, while propranolol increased it.

    Conclusions:

    • Nonselective beta-receptor stimulation (isoproterenol) affects cardiac output via direct cardiac actions and influences venous return.
    • Beta-receptor blockade (propranolol) also influences cardiac output through direct cardiac effects and by altering venous return.
    • These findings highlight the complex interplay between beta-adrenergic activity, cardiac dimensions, and overall cardiac output.