The haemodynamic effect and isoprenaline antagonism of a new beta adrenergic blocking drug, Kö 1366, was investigated in healthy volunteers, comparing with the effect of propranolol. Furtheremore Kö 1366 was administered to patients with ischaemic heart disease for measurement of heart rate, blood pressure and cardiac effort index at rest and on exercise.
Following intravenous administration of 1, 2, 2.5, and 3mg Kö 1366, changes in heart rate, blood pressure and cardiac effort index were observed. 2.5-3mg Kö 1366 was roughly equivalent in potency to 10mg of propranolol intravenously administered. In respect of decrease in cardiac index and stroke volume index, 2.5mg Kö 1366 intravenously administered was equivalent to or slightly less effective than 10mg propranolol. In terms of isoprenaline antagonism, the effect of 3mg Kö 1366 on heart rate was more marked than that of 10mg propranolol, and on cardiac effort index 1mg of Kö 1366 was more active than 10mg of propranolol. The inhibiting effect on cardiac index increase following isoprenaline was less pronounced than that by 10mg propranolol, and that of Kö 1366 on stroke volume index increase was nearly equivalent to that of propranolol. From these results, the Kö 1366 to propranolol potency ratio is estimated at 3-4 to 1.
After oral administration of 10-45mg per day of Kö 1366 to patients with ischaemic heart disease, heart rate, blood pressure and cardiac effort index were measured at rest and on exercise. It was found that Kö 1366 produced a slight decrease in heart rate, blood pressure and cardiac effort index at rest, but increases in heart rate, cardiac effort index and blood pressure on exercise were considerably inhibited by doses of 15mg or more. Fifteen to 30mg Kö 1366 is considered a suitable daily dose in the treatment of the patients with ischaemic heart disease.
View full abstract