Effects of carvedilol on the metabolic, hemodynamic, and electrocardiographic responses to increased plasma epinephrine in normal subjects.
To study the effects of the new vasodilating beta-blocking agent carvedilol on a variety of metabolic, hemodynamic, and ECG parameters of importance for the clinical outcome of acute myocardial infarction (AMI), we infused epinephrine (EPI) in healthy male volunteers on two separate occasions to serum concentrations of the same level reached in AMI. Before the EPI infusions, the volunteers were pretreated for 2 weeks with either carvedilol or placebo in randomized order. EPI caused significant decreases in serum levels: S-potassium (0.62 mM), S-magnesium (0.07 mM), S-calcium (0.12 mM), and S-phosphate (0.26 mM). After pretreatment with carvedilol, the decreases in S-calcium and S-phosphate were partly prevented and those in S-potassium and S-magnesium were completely inhibited. Short-term treatment with carvedilol significantly decreased S-insulin and serum C-peptide and significantly attenuated the EPI-induced increase in B-glucose observed after placebo. The EPI infusion significantly increased serum concentrations of free fatty acids and glycerol. These increases were significantly attenuated by carvedilol, whereas carvedilol had no significant affects of a variety of other lipid variables. EPI infusion caused a significant (p < 0.01) increase in systolic blood pressure (SBP) from 124.8 +/- 8.1 to 135.8 +/- 12.5 mm Hg and an increase in heart rate (HR) from 71.0 +/- 11.5 to 77.2 +/- 12.2, resulting in a significant increase in rate-pressure product (RPP). This estimate of cardiac work was significantly (p < 0.05) reduced by pretreatment with carvedilol.(ABSTRACT TRUNCATED AT 250 WORDS)
Hansen
O
O
Section of Cardiology, General Hospital, Malmö, Sweden.
Johansson
B W
BW
Nilsson-Ehle
P
P
Eklund
B
B
Ohlsson
I
I
Palenmark
E
E
Pauler
A M
AM
Svensson
K
K
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D002227:Carbazoles / Q000494:pharmacology*; D000077261:Carvedilol; D004347:Drug Interactions; D004562:Electrocardiography / Q000187:drug effects*; D004573:Electrolytes / Q000097:blood; D004837:Epinephrine / Q000097:blood / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008055:Lipids / Q000097:blood; D008297:Male; D009203:Myocardial Infarction / Q000517:prevention & control; D011412:Propanolamines / Q000494:pharmacology*
D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D002227:Carbazoles; D004573:Electrolytes; D008055:Lipids; D011412:Propanolamines; D000077261:Carvedilol; D004837:Epinephrine