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  • 1
    Electronic Resource
    Electronic Resource
    Effect of enoximone alone and in combination with metoprolol on myocardial function and energetics in severe congestive heart failure: Improvement in hemodynamic and metabolic profile (1993)
    Springer
    Cardiovascular drugs and therapy 7 (1993), S. 337-347 
    Details
    ISSN: 1573-7241
    Keywords: myocardial energetics ; congestive heart failure ; enoximone ; beta-adrenergic blockade ; metoprolol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The hemodynamic and myocardial metabolic effects of enoximone (phosphodiesterase III inhibitor), alone or in combination with metoprolol (beta-adrenergic blocker), were studied in patients with congestive heart failure. Ten patients (New York Heart Association Class III–IV) underwent right heart and coronary sinus catheterization, and parameters were assessed at basal condition, at peak enoximone response (mean intravenous loading dose=2.2 mg/kg), and after the combination with metoprolol (mean intravenous dose=8.5 mg). Heart rate tended to increase during enoximone administration (from 102±16 to 107±16 min−1, ns) and was reduced during enoximone plus metoprolol (to 88±15 min−1, p〈0.05 vs. basal). Cardiac index was increased during enoximone (from 2.2±0.2 to 3.8±0.5 1/min/m2, p〈0.05) and decreased during enoximone plus metoprolol (to 2.8±0.5 1/min/m2, p〈0.05 vs. enoximone). Mean pulmonary wedge pressure fell during enoximone and remained reduced during enoximone plus metoprolol (from 27±9 to 9±3 and to 13±4 mmHg, respectively, both p〈0.05). Myocardial oxygen consumption did not change during enoximone (from 27±8 to 25±13 ml/min, ns) and was reduced during enoximone plus metoprolol (to 19±8 ml/min, p〈0.05 vs. basal). Myocardial lactate extraction tended to be lower during enoximone and during enoximone plus metoprolol conditions (from 38±17% to 26±20% and to 29±24%, respectively), but no statistical significance was found. Myocardial efficiency was increased during enoximone and during enoximone plus metoprolol (from 9±3% to 15±6% and to 14±6%, respectively, both p〈0.05). Thus in patients with congestive heart failure enoximone improves hemodynamics and, in most cases, it does not influence energetics. The addition of metoprolol to enoximone reduces heart rate, cardiac index, and myocardial oxygen consumption without any other major changes, producing a more physiologic hemodynamic and metabolic profile.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00880157
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Myocardial, coronary, and peripheral effects of xamoterol (ICI 118,587) in open-chest pigs (1989)
    Springer
    Cardiovascular drugs and therapy 3 (1989), S. 91-97 
    Details
    ISSN: 1573-7241
    Keywords: xamoterol ; noradrenaline ; beta receptors ; cardiac actions ; vascular effects ; coronary effect
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The hemodynamic and coronary effects of increasing doses of xamoterol, a beta-adrenoceptor partial agonist, were assessed in an anesthetized pig preparation in which cardiovascular reflexes were abolished and sympathetic tone was modified by infusion of noradrenaline (NA). Xamoterol, in basal conditions, increased heart rate (HR) from 104±12 to 120±13 beats/min (p〈.001); systolic, diastolic, and mean blood pressure, respectively, from 77±8 to 103±17 mmHg (p〈.01), from 48±7 to 70±12 mmHg (p〈.01), and from 58±7 to 84±14 mmHg (p〈.01); left ventricular dP/dT max from 2098±564 to 4205±937 mmHg/sec (p〈.001); and systemic vascular resistance (SVR) from 1745±564 to 2270±739 dynes sec cm−5 (p〈.01). The increase in HR and dP/dT max brought about by xamoterol was about 37% and 56%, resectively, of the maximum increase produced by NA. At the highest level of sympathetic tone, xamoterol reduced HR from 148±11 to 122±11 beats/min (p〈.001) and no significant change was observed in dP/dT max. The increase in blood pressure and SVR induced by xamoterol was maintained at each level of sympathetic tone. On the contrary, SVR did not change after NA, as expected, since receptors were fully blocked. For a given inotropic effect, xamoterol and NA produced a similar increase in coronary blood flow and myocardial O2 consumption. In conclusion, the results indicate that, in the areflexic pig, xamoterol acts as a partial beta1-agonist, with a more potent positive inotropic than chronotropic effect in basal conditions. At the highest level of sympathetic tone, it does antagonize the chronotropic, but not the inotropic, effect of NA. Xamoterol increases peripheral resistance and blood pressure possibly through a beta2 vascular blocking action, and the increase in contractility induced by xamoterol is paralleled by an increase in myocardial O2 consumption. No direct effects on coronary circulation are observed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01881533
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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