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. 1982 Jul 31;285(6338):325–327. doi: 10.1136/bmj.285.6338.325

Haemodynamic advantages of combined alpha-blockade and beta-blockade over beta-blockade alone in patients with coronary heart disease.

S H Taylor, B Silke, G I Nelson, R C Okoli, R C Ahuja
PMCID: PMC1498994  PMID: 6807469

Abstract

The acute haemodynamic effects of beta-blockade with propranolol and combined alpha-blockade and beta-blockade with labetalol were compared in a randomised study in 12 patients with coronary artery disease proved by angiography. Propranolol induced significantly greater depression of left ventricular function both at rest and during exercise than labetalol. This difference was probably attributable to the vasodilator activity of labetalol and the associated reduction in afterload offsetting the haemodynamic disadvantages of blockade of cardiac beta-adrenoceptors alone. The haemodynamic advantages of combined alpha-blockade and beta-blockade over beta-blockade alone may thus have therapeutic implications for the use of these treatments in patients with coronary heart disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Braunwald E. Thirteenth Bowditch lecture. The determinants of myocardial oxygen consumption. Physiologist. 1969 May;12(2):65–93. [PubMed] [Google Scholar]
  2. Chamberlain D. A. Effects of beta adrenergic blockade on heart size. Am J Cardiol. 1966 Sep;18(3):321–328. doi: 10.1016/0002-9149(66)90049-x. [DOI] [PubMed] [Google Scholar]
  3. Coltart J., Alderman E. L., Robison S. C., Harrison D. C. Effect of propranolol on left ventricular function, segmental wall motion, and diastolic pressure-volume relation in man. Br Heart J. 1975 Apr;37(4):357–364. doi: 10.1136/hrt.37.4.357. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dehmer G. J., Falkoff M., Lewis S. E., Hillis L. D., Parkey R. W., Willerson J. T. Effect of oral propranolol on rest and exercise left ventricular ejection fraction, volumes, and segmental wall motion in patients with angina pectoris. Assessment with equilibrium gated blood pool imaging. Br Heart J. 1981 Jun;45(6):656–666. doi: 10.1136/hrt.45.6.656. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Eroğlu L., Atamer-Simsek S., Yazici O., Keyer-Uysal M., Yüksel S. A study of the relationship between serum lithium and plasma cortisol levels in manic depressive patients. Br J Clin Pharmacol. 1979 Jul;8(1):89–90. doi: 10.1111/j.1365-2125.1979.tb05917.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hansteen V., Møinichen E., Lorentsen E., Andersen A., Strøm O., Søiland K., Dyrbekk D., Refsum A. M., Tromsdal A., Knudsen K. One year's treatment with propranolol after myocardial infarction: preliminary report of Norwegian multicentre trial. Br Med J (Clin Res Ed) 1982 Jan 16;284(6310):155–160. doi: 10.1136/bmj.284.6310.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Reale A., Nigri A., Gioffrè P. A., Motolese M. Acute influence of different beta-blocking agents upon left heart hemodynamics at rest and during exercise in patients with coronary artery disease. Eur J Cardiol. 1979 Feb;9(2):101–109. [PubMed] [Google Scholar]
  8. Richards D. A., Prichard B. N., Dobbs R. J. Adrenoceptor blockade of the circulatory responses to intravenous isoproterenol. Clin Pharmacol Ther. 1978 Sep;24(3):264–273. doi: 10.1002/cpt1978243264. [DOI] [PubMed] [Google Scholar]
  9. Sonnenblick E. H., Ross J., Jr, Covell J. W., Kaiser G. A., Braunwald E. Velocity of contraction as a determinant of myocardial oxygen consumption. Am J Physiol. 1965 Nov;209(5):919–927. doi: 10.1152/ajplegacy.1965.209.5.919. [DOI] [PubMed] [Google Scholar]
  10. Taylor S. H., Silke B. Haemodynamic effects of beta-blockade in ischaemic heart failure. Lancet. 1981 Oct 17;2(8251):835–837. doi: 10.1016/s0140-6736(81)91105-3. [DOI] [PubMed] [Google Scholar]
  11. Taylor S. H., Silke B., Lee P. S. Intravenous beta-blockade in coronary heart disease: is cardioselectivity or intrinsic sympathomimetic activity hemodynamically useful? N Engl J Med. 1982 Mar 18;306(11):631–635. doi: 10.1056/NEJM198203183061102. [DOI] [PubMed] [Google Scholar]
  12. Thadani U., Davidson C., Singleton W., Taylor S. H. Comparison of the immediate effects of five beta-adrenoreceptor-blocking drugs with different ancillary properties in angina pectoris. N Engl J Med. 1979 Apr 5;300(14):750–755. doi: 10.1056/NEJM197904053001402. [DOI] [PubMed] [Google Scholar]
  13. White C. B., Udwadia B. P. Beta-adrenoceptors in the human dorsal hand vein, and the effects of propranolol and practolol on venous sensitivity to noradrenaline. Br J Clin Pharmacol. 1975 Apr;2(2):99–105. doi: 10.1111/j.1365-2125.1975.tb01564.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Yusuf S., Ramsdale D., Peto R., Furse L., Bennett D., Bray C., Sleight P. Early intravenous atenolol treatment in suspected acute myocardial infarction. Preliminary report of a randomised trial. Lancet. 1980 Aug 9;2(8189):273–276. doi: 10.1016/s0140-6736(80)90231-7. [DOI] [PubMed] [Google Scholar]

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