Key result
Co-administration of atenolol and prazosin reduced phase 2 ventricular premature beats compared to vehicle (1.25 vs 2.43 log10-transformed totals; P<0.05).
Why the study?
Does combined alpha-1 and beta-1 adrenoceptor blockade reduce phase 2 ventricular arrhythmias in a rat model of myocardial infarction?
RCT
randomized
Does combined alpha-1 and beta-1 adrenoceptor blockade reduce phase 2 ventricular arrhythmias in a rat model of myocardial infarction?
Combined alpha-1 and beta-1 adrenoceptor blockade reduces phase 2 ventricular arrhythmias in a rat model of myocardial infarction, an effect dependent on neutrophils.
Answers are grounded in this paper and cite their sources.
Combined alpha-1/beta-1 blockade warrants further mechanistic study in rodent MI; leaves open neutrophil-dependent translation to human arrhythmia prevention.
BACKGROUND AND PURPOSE: The mechanisms responsible for phase 2 (infarct-related) ventricular arrhythmias remain unclear. We have investigated the role of alpha(1) and beta(1) adrenoceptor activation and the interaction of this with infarct neutrophil accumulation, in anaesthetized rats. EXPERIMENTAL APPROACH: Neutrophil-replete Sprague-Dawley rats (n = 8-9 per group) were anaesthetized and randomized to receive vehicle, prazosin (0.5 mg.kg(-1) i.v.), atenolol (4 mg.kg(-1) i.v.) or their combination prior to left main coronary artery occlusion. A further group was depleted of neutrophils and received both atenolol and prazosin. Coronary ligation in all groups was maintained for 240 min. KEY RESULTS: Atenolol and prazosin treatment lowered heart rates and blood pressures respectively, but neither agent given alone affected the incidence of phase 2 ventricular tachycardia or fibrillation. However, co-administration of atenolol with prazosin reduced phase 2 ventricular premature beats (log(10)-transformed totals were 1.25 +/- 0.26 vs. 2.43 +/- 0.18 in controls; P < 0.05). Neutrophil depletion attenuated this antiarrhythmic effect (log(10)-transformed total ventricular premature beats were 1.66 +/- 0.35; P > 0.05 vs. controls). CONCLUSIONS AND IMPLICATIONS: Phase 2 arrhythmias appear to depend in part on a complex interaction between catecholamines and neutrophils. A model of this interaction is proposed.
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Clements‐Jewery et al. (2009) conducted an RCT in phase 2 (infarct-related) ventricular arrhythmias. Atenolol and prazosin combination vs. vehicle was evaluated on phase 2 ventricular premature beats (log10-transformed totals) (p=<0.05). Co-administration of atenolol and prazosin reduced phase 2 ventricular premature beats compared to vehicle (1.25 vs 2.43 log10-transformed totals; P<0.05).
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