[Treatment of patients with myocardial infarct and hyperdynamic syndrome with propranolol]

A total of 139 patients with myocardial infarction (MI) and the hyperdynamic syndrome were investigated. To 67 of those, the beta-adrenoblocker propranolol was administered intravenously on the first day of the disease, with a series of further injections over the next 9 days, on average, under central hemodynamic control. Hemodynamic parameters were assessed by means of integral rheography and polycardiography, the MI size was measured by precardial charting (from 35 ECG leads) and serial evaluations of CPK and MB (the latter's isoenzyme) activity. Propranolol administered in the early hours after the infarction reduced heart performance and hence functional load on the myocardium, which improved the latter's contractility. The efficiency of propranolol treatment was dependent on the time of first administration. When administered early (within 5 hours of the attack), the drug reduced the MI size by 56% as compared to the controls, whereas late administration (12-24 hours after the attack) produced a 12% reduction. Regular propranolol treatment in patients with the hyperdynamic syndrome reduced the frequency of certain MI complications, such as prolonged course with relapses, acute congestive failure, rhythm and conductivity disorders, and total mortality.