抄録
Systemic and coronary hemodynamic effects of acebutolol (10mg i.v.), a cardioselective β-adrenoceptor blocking agent were investigated in 11 patients with coronary artery disease and significant arterial obstructive lesions. Efficacy was assessed by simultaneous left and right heart catheterization and with an inlaying Webster thermodilution catheter in the coronary sinus. The data were compared with data from 7 other patients who received 2mg i.v. of propranolol, a non-cardioselective β-blocker. With acebutolol, (1) the heart rate was reduced significantly (p<0.01), (2) no significant changes were observed in the LVSP, LVEDP, mean PWP, LVmax dp/dt/p, LV negative dp/dt/p, CI, SWI and SPI, (3) CSF and MVO2 decreased significantly (p<0.01) 5min after injection and (4) the CVR showed a significant elevation (p<0.05) after 5min. With propranolol, (1) the heart rate decreased significantly (p<0.05), (2) there were no significant changes in LVSP and LVEDP, (3) the mean PWP increased significantly (p<0.05), (4) the LVmax dp/dt/p, CI and SWI decreased significantly (p<0.05), (5) the CSF and MVO2 decreased markedly (p<0.01) and (6) the CVR increased markedly (p<0.01).
Was compared to the effects of 2mg i.v. of propranolol, those produced by acebutolol (10mg i.v.) were characterized by a predominant negative chronotropic action with minimal negative inotropic action, combined with a reduction in CSF and MVO2. The findings suggest that the efficacy of acebutolol in pump failure caused by myocardial ischemia during effort angina is mediated by improvement of the myocardial oxygen demand-supply imbalance.
