Hemodynamic Response to Exercise After Beta-Adrenergic and Parasympathetic Blockade

Cardiac responses to supine bicycle exercise were studied in six normal subjects after the intravenous administration of 5 mg of propranolol and again after the additive effect of 0.03 mg/kg of atropine. Mean resting heart rate was decreased 15 beats/min by propranolol and then increased by 38 beats/min after atropine. Mean exercise heart rate was 157 for control exercise, 119 after propranolol and 143 after propranolol + atropine. The resting cardiac index was reduced 21% by propranolol and restored to control values after atropine. The mean control exercise cardiac index was 7.2 l/min per m 2 ; this was reduced to 5.8 after propranolol and increased to 6.2 after atropine. The mean stroke index was not altered by control exercise, increased 3 ml/beat per m 2 with exercise after propranolol and increased 6 ml/beat per m 2 with exercise after propranolol + atropine. Resting pulmonary artery, aortic and left-ventricular end-diastolic pressures were not altered by propranolol or by propranolol + atropine. The mean control exercise left-ventricular end-diastolic pressure was 9 mm Hg, increased to 19 mm Hg after propranolol and fell to 12 mm Hg after propranolol + atropine. The mean exercise aortic systolic pressure was 10 mm Hg below the value for control exercise after propranolol and 8 mm Hg below control after propranolol + atropine. Atropine lessens the inhibition of the cardiac response to exercise with beta adrenergic inhibition, possibly by increasing the heart rate.