[Neither propranolol nor the vasodilating beta-blocker carvedilol have a direct effect on coronary resistance vessels].
Seventeen patients with coronary heart disease were included in a double-blind randomized study. They received either 5 mg of carvedilol or 6 mg of propranolol intravenously. Heart rate, aortic pressure, mean coronary sinus pressure and coronary flow (thermodilution) were measured, and coronary resistance and rate-pressure product were calculated before and 15 min after the infusion, which lasted 10 min. Carvedilol lowered significantly (p less than 0.05) heart rate (mean 76 to 69/min), aortic pressure (mean 153/80 to 135/72 mm Hg), rate-pressure product (mean 117 to 93 mm Hg/min) and coronary flow (mean 114 to 94 ml/min). Coronary resistance and coronary flow related to rate-pressure product showed no significant change after carvedilol. Propranolol lowered heart rate (mean 76 to 64/min; p less than 0.05) and rate-pressure product (mean 109 to 96 mm Hg/min; ns). Aortic pressure, coronary flow, coronary resistance, and coronary flow related to rate-pressure product showed no significant change after propranolol. Thus, carvedilol lowered rate-pressure product more markedly than propranolol on account of its acute blood-pressure lowering effect. Neither drug seems to have a direct influence on coronary resistance vessels.
Kardiologisches Fachkrankenhaus, Herz- und Kreislaufzentrum Rotenburg a.d.F.
H
H
Sievert
T
T
Schmidt
G
G
Frey
R
R
Schräder
R
R
van der Does
M
M
Kaltenbach
G
G
Kober
D000319:Adrenergic beta-Antagonists; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000008:administration & dosage*; D000077261:Carvedilol; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D011412:Propanolamines / Q000008:administration & dosage*; D011433:Propranolol / Q000008:administration & dosage*; D014655:Vascular Resistance / Q000187:drug effects*; D014665:Vasodilator Agents
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D014665:Vasodilator Agents; D000077261:Carvedilol; D011433:Propranolol
Weder Propranolol noch der vasodilatierende beta-Blocker Carvedilol besitzen eine direkte Wirkung auf die koronaren Widerstandsgefässe.