Influence of carvedilol and propranolol on coronary blood flow.
A total of 17 patients with angiographically proven coronary artery disease and at least one stenosis blocking greater than or equal to 70% of the left anterior descending or circumflex artery were included in a double-blind, randomized study. They received either 5 mg carvedilol or 6 mg propranolol intravenously. Heart rate, aortic pressure, mean coronary sinus pressure and coronary flow (thermodilution) were measured and coronary resistance and the rate-pressure product were calculated before and 25 min after injection. Carvedilol significantly (P less than 0.05) lowered the heart rate (mean, 76 to 69 beats/min), aortic pressure (mean, 153/80-135/72 mm Hg), rate-pressure product (mean, 117-93 mm Hg/min), and coronary flow (mean, 114-94 ml/min). Coronary resistance (mean, 0.97-1.07 mm Hg x min/ml) and coronary flow related to the rate-pressure product (mean, 1.0-1.02 ml/mm Hg) showed no significant change after carvedilol treatment. Propranolol lowered the heart rate (mean, 76-64/min; P less than 0.05) and rate-pressure product (mean, 109-96 mm Hg/min; not significant). Aortic pressure (mean, 145/72-147/74 mm Hg), coronary flow (mean 109-101 ml/min), coronary resistance (mean, 1.1-1.2 mm Hg x min/ml), and coronary flow related to the rate-pressure product (mean, 1.12-1.19 ml/mm Hg) showed no significant change after propranolol administration. Following single application, carvedilol lowered the rate-pressure product more markedly than did propranolol on account of its acute blood-pressure-lowering effect. No differences in the hemodynamic effects of carvedilol and propranolol were found. Neither drug seems to influence the adaption of coronary flow to myocardial oxygen demand.
Sievert
H
H
Abteilung für Kardiologie, Klinikum der Universität, Frankfurt, Federal Republic of Germany.
Frey
G
G
Schräder
R
R
Schmidt
T
T
van der Does
R
R
Kaltenbach
M
M
Kober
G
G
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000494:pharmacology* / Q000627:therapeutic use; D000077261:Carvedilol; D003326:Coronary Circulation / Q000187:drug effects*; D003327:Coronary Disease / Q000503:physiopathology; D004311:Double-Blind Method; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption / Q000187:drug effects; D011412:Propanolamines / Q000494:pharmacology* / Q000627:therapeutic use; D011433:Propranolol / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic; D014655:Vascular Resistance / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D011433:Propranolol