Effects of acetylstrophanthidin on baroreflex sensitivity in patients with acute myocardial infarction

Autor: Valter Bianchi, Mario Petretta, Gianfranco Morgano, Assunta Carpinelli, Giuseppe Valva, Sakis Themistoclakis, Francesco Rotondi, Domenico Bonaduce
Přispěvatelé: Bonaduce, Domenico, Petretta, Mario, Morgano, G, Bianchi, V, Themistoclakis, S, Rotondi, F, Valva, G, Carpinelli, A.
Jazyk: angličtina
Rok vydání: 1993
Předmět:
Chronotropic
Adult
Male
medicine.medical_specialty
Baroreceptor
Time Factors
Myocardial Infarction
Hemodynamics
Infarction
Blood Pressure
Strophanthidin
Baroreflex
Heart Rate
Internal medicine
Heart rate
medicine
Humans
acetylstrophanthidin
phenylephrine

cardiovascular diseases
Myocardial infarction
Aged
business.industry
Stroke Volume
Middle Aged
medicine.disease
Blood pressure
acute heart infarction
adult
aged
article
clinical article
clinical trial
controlled study
female
human
intravenous drug administration
male
pressoreceptor reflex
priority journal
receptor sensitivity

Anesthesia
cardiovascular system
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Adult
Aged
Baroreflex
Blood Pressure
Female
Heart Rate
Human
Male
Middle Age
Myocardial Infarction
Stroke Volume
Strophanthidin
Time Factors

circulatory and respiratory physiology
Popis: We evaluated the effects of acetylstrophanthidin on baroreflex sensitivity in patients soon after an acute myocadial infarction. Baroreflex control of heart rate is frequently depressed after acute myocardial infarction and few data are available as to the effects of pharmacological intervention on this parameter. The reflex chronotropic response to arterial baroreceptor stimulation was assessed in 29 patients with uncomplicated acute myocardial infarction in control conditions (72-96 h after symptom onset) and 30 min after acetylstrophanthidin administration. To check for spontaneous baroreflex sensitivity variations, 24 patients with the same characteristics were evaluated at the same time intervals before and after a 10-cc bolus of saline placebo. Baroreflex sensitivity was assessed by calculating the regression line relating phenylephrine-induced increases in systolic blood pressure to the attendant changes in RR intervals. Mean baseline baroreflex sensitivity value for the whole study population was 7.4 ± 4.5 ms/mmHg and was unchanged, 7.0 ± 4.5 ms/mmHg, after acetylstrophanthidin (P=NS). Mean baroreflex sensitivity values were also comparable dividing patients according to the site of infarction both before and after acetylstrophanthidin. Despite the lack of difference in mean baroreflex sensitivity values between the two studies, at a post hoc analysis an inverse relation was found in the total study population between baseline baroreflex sensitivity values and their changes after acetylstrophanthidin (r = -0.62; P < 0.005). The inverse relation was also evident separately in anterior (r = -0.57; P < 0.05) and in inferior (r =-0.70; P < 0.005) myocardial infarction patients. In the control group no difference was observed between mean baroreflex sensitivity values obtained in the two studies, nor was there any relationship between baseline baroreflex sensitivity values and their changes after placebo administration. These data demonstrate that after myocardial infarction acetylstrophanthidin administration had no effect on mean baroreflex sensitivity value. However, this drug seems to improve baroreflex sensitivity when it is depressed and to worsen it when normal or nearly normal.
Databáze: OpenAIRE