Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1970 Mar;32(2):219–225. doi: 10.1136/hrt.32.2.219

Effects of propranolol on response to exercise in hypertrophic obstructive cardiomyopathy

R H T Edwards 1,1, A Kristinsson 1,2, D A Warrell 1,3, J F Goodwin 1
PMCID: PMC487306  PMID: 5462284

Abstract

The circulatory, respiratory, and metabolic responses to steady state submaximal exercise have been studied in four women and two men with hypertrophic obstructive cardiomyopathy, before treatment, after intravenous, and after three months of oral propranolol.

The physical working capacity was significantly lower than in normal subjects, and the response to exercise was characterized by a tachycardia, low cardiac output and stroke volume, and high ventilation and blood lactate concentration. After propranolol there was a significant reduction in heart rate, but changes in most other measurements were slight and there was no improvement in effort tolerance though angina was relieved in the two patients in whom it was present. The possible causes of breathlessness and effort intolerance in hypertrophic obstructive cardiomyopathy are discussed in relation to known effects of propranolol. It is concluded that further trial of propranolol and other beta-adrenergic blocking agents is warranted.

Full text

PDF
225

Selected References

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

  1. BERNEUS B., CARLSTEN A., HOLMGREN A., SELDINGER S. I. Percutaneous catheterization of peripheral arteries as a method for blood sampling. Scand J Clin Lab Invest. 1954;6(3):217–221. [PubMed] [Google Scholar]
  2. Cohen L. S., Braunwald E. Amelioration of angina pectoris in idiopathic hypertrophic subaortic stenosis with beta-adrenergic blockade. Circulation. 1967 May;35(5):847–851. doi: 10.1161/01.cir.35.5.847. [DOI] [PubMed] [Google Scholar]
  3. Cumming G. R., Carr W. Hemodynamic response to exercise after propranolol in normal subjects. Can J Physiol Pharmacol. 1966 May;44(3):465–474. doi: 10.1139/y66-055. [DOI] [PubMed] [Google Scholar]
  4. DOLLERY C. T., HUGH-JONES P. Distribution of gas and blood in the lungs in disease. Br Med Bull. 1963 Jan;19:59–65. doi: 10.1093/oxfordjournals.bmb.a070008. [DOI] [PubMed] [Google Scholar]
  5. Edwards R. H., Jones N. L., Oppenheimer E. A., Hughes R. L., Knill-Jones R. P. Interrelation of responses during progressive exercise in trained and untrained subjects. Q J Exp Physiol Cogn Med Sci. 1969 Oct;54(4):394–403. doi: 10.1113/expphysiol.1969.sp002038. [DOI] [PubMed] [Google Scholar]
  6. Eliasch H., Rosén A., Scott H. M. Systemic circulatory response to stress of simulated flight and to physical exercise before and after propranolol blockade. Br Heart J. 1967 Sep;29(5):671–683. doi: 10.1136/hrt.29.5.671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Epstein S., Robinson B. F., Kahler R. L., Braunwald E. Effects of beta-adrenergic blockade on the cardiac response to maximal and submaximal exercise in man. J Clin Invest. 1965 Nov;44(11):1745–1753. doi: 10.1172/JCI105282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. FILLEY G. F., GREGOIRE F., WRIGHT G. W. Alveolar and arterial oxygen tensions and the significance of the alveolar-arterial oxygen tension difference in normal men. J Clin Invest. 1954 Apr;33(4):517–529. doi: 10.1172/JCI102922. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Flamm M. D., Harrison D. C., Hancock E. W. Muscular subaortic stenosis. Prevention of outflow obstruction with propranolol. Circulation. 1968 Nov;38(5):846–858. doi: 10.1161/01.cir.38.5.846. [DOI] [PubMed] [Google Scholar]
  10. HOHORST H. J. Enzymatische Bestimmung von L(+)-Milchsäure. Biochem Z. 1957;328(7):509–521. [PubMed] [Google Scholar]
  11. Hamer J., Sowton E. Effects of propranolol on exercise tolerance in angina pectoris. Am J Cardiol. 1966 Sep;18(3):354–360. doi: 10.1016/0002-9149(66)90053-1. [DOI] [PubMed] [Google Scholar]
  12. Higgs B. E., Clode M., McHardy G. J., Jones N. L., Campbell E. J. Changes in ventilation, gas exchange and circulation during exercise in normal subjects. Clin Sci. 1967 Apr;32(2):329–337. [PubMed] [Google Scholar]
  13. Hughes R. L., Clode M., Edwards R. H., Goodwin T. J., Jones N. L. Effect of inspired O2 on cardiopulmonary and metabolic responses to exercise in man. J Appl Physiol. 1968 Mar;24(3):336–347. doi: 10.1152/jappl.1968.24.3.336. [DOI] [PubMed] [Google Scholar]
  14. Jones N. L., Campbell E. J., McHardy G. J., Higgs B. E., Clode M. The estimation of carbon dioxide pressure of mixed venous blood during exercise. Clin Sci. 1967 Apr;32(2):311–327. [PubMed] [Google Scholar]
  15. Mason D. T., Braunwald E., Ross J., Jr Effects of changes in body position on the severity of obstruction to left ventricular outflow in idiopathic hypertrophic subaortic stenosis. Circulation. 1966 Mar;33(3):374–382. doi: 10.1161/01.cir.33.3.374. [DOI] [PubMed] [Google Scholar]
  16. McHardy G. J. The relationship between the differences in pressure and content of carbon dioxide in arterial and venous blood. Clin Sci. 1967 Apr;32(2):299–309. [PubMed] [Google Scholar]
  17. Richardson P. S., Sterling G. M. Effects of beta-adrenergic receptor blockade on airway conductance and lung volume in normal and asthmatic subjects. Br Med J. 1969 Jul 19;3(5663):143–145. doi: 10.1136/bmj.3.5663.143. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Robinson B. F. Mode of action of nitrglycerin in angina pectoris. Correlation between haemodynamic effects during exercise and prevention of pain. Br Heart J. 1968 May;30(3):295–302. doi: 10.1136/hrt.30.3.295. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Sloman G. Propranolol in management of muscular subaortic stenosis. Br Heart J. 1967 Sep;29(5):783–787. doi: 10.1136/hrt.29.5.783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Ulrych M., Frohlich E. D., Dustan H. P., Page I. H. Immediate hemodynamic effects of beta-adrenergic blockade with propranolol in normotensive and hypertensive man. Circulation. 1968 Mar;37(3):411–416. doi: 10.1161/01.cir.37.3.411. [DOI] [PubMed] [Google Scholar]
  21. Wolfson S., Heinle R. A., Herman M. V., Kemp H. G., Sullivan J. M., Gorlin R. Propranolol and angina pectoris. Am J Cardiol. 1966 Sep;18(3):345–353. doi: 10.1016/0002-9149(66)90052-x. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES