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May 1, 1980Circulation

Use of catheter-tip velocity--pressure transducer to evaluate left ventricular function in man: effects of intravenous propranolol.

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Why the study?

Does intravenous propranolol reduce left ventricular function in patients without heart failure?

Population

9 patients without clinical evidence of heart failure

Comparison

Intravenous propranolol 10 mg vs Baseline measurements prior to drug administration

Design

Case_series

Follow-up

continuous during drug administration

Authors

WKW. Peter KlinkeVictoria Heart Institute FoundationLCL. G. ChristieInstitute of Biological, Environmental and Rural SciencesWNWilmer W. NicholsVascular / Pulmonary Vascular

Discussion

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Implication

IV propranolol may reduce LV function in non-HF patients; hypothesis-generating case series leaves relevance to practice open.

Key Points

  • The aim is to evaluate the left ventricular hemodynamic effects of intravenous propranolol in individuals without heart failure.
  • Measured continuous pulsatile ascending aortic blood flow velocity and pressure during propranolol administration in nine patients.
  • Determined beat-to-beat changes in various hemodynamic parameters including stroke volume index and maximum LV dP/dt.
  • No prior clinical evidence of heart failure in subjects.
  • Propranolol decreased maximum blood flow velocity from 58 +/- 4.7 to 42 +/- 5.1 cm/sec, p<0.002.
  • Maximum dP/dt decreased from 1361 +/- 70 to 1146 +/- 63 mm Hg/sec, p<0.002.
  • Stroke volume index reduced from 47 +/- 3.0 to 38 +/- 3.2 ml/m2, p<0.002.

Structured PICO

Does intravenous propranolol reduce left ventricular function in patients without heart failure?

P
Population
9 patients without clinical evidence of heart failure
I
Intervention
Intravenous propranolol 10 mg
C
Comparator
Baseline measurements prior to drug administration
O
Outcome
Beat-to-beat changes in stroke volume index, stroke work index, left ventricular end-diastolic pressure, maximum blood flow velocity and acceleration, and maximum left ventricular dP/dtsurrogate

A multisensor catheter technique can rapidly detect the significant depression in myocardial function caused by intravenous propranolol in conscious patients.

Cite This Study

Klinke et al. (1980) studied this question.

synapsesocial.com/papers/6a7154276c240de38cdc197chttps://doi.org/10.1161/01.cir.61.5.946
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of Beta-Adrenergic Blockade (Propranolol) on Left Ventricular Hemodynamics and the Electrocardiogram During Exercise-Induced Angina Pectoris1968 · 72 citations
  2. 2Measurement of Instantaneous Blood Flow Velocity and Pressure in Conscious Man with a Catheter-Tip Velocity Probe1969 · 188 citations
  3. 3The maximum derivatives of left ventricular pressure and transverse internal diameter as indices of the inotropic state of the left ventricle in conscious dogs1973 · 43 citations
  4. 4Left Ventricular Ejection in Conscious Dogs:1966 · 202 citations
  5. 5Sequential Velocity Development in the Ascending and Descending Aorta of the Dog1972 · 52 citations