Blood pressure, plasma atrial natriuretic peptide and catecholamines during rapid ventricular pacing and effects of beta-adrenergic blockade in coronary artery disease

The American Journal of Cardiology
K J PeuhkurinenJ Takkunen

Abstract

To study neurohumoral control mechanisms of the hemodynamic response to ventricular tachycardia, arterial blood pressure, plasma atrial natriuretic peptide (ANP) and catecholamine levels were monitored during simulated ventricular tachycardia before and after administration of beta blockade. Tachycardia was simulated by ventricular pacing at 150 beats/min for 150 seconds in 9 patients without and 14 with angiographically demonstrable coronary artery disease (CAD). The effects of intravenous propranolol (0.15 mg/kg) were evaluated in 7 control subjects and in 13 patients with CAD. Arterial blood pressure decreased to its minimum within 5 seconds after onset of pacing in all patients, the decrease being 27 and 30% (p = not significant) in the groups without and with CAD, respectively. Propranolol did not affect the initial decline, but blunted subsequent recovery. The ANP baseline levels were similar in both groups, increasing by 60% (p less than 0.05) and 71% (p less than 0.02) in the groups without and with CAD, respectively, during ventricular pacing. After administration of propranolol the increase in ANP was 180% in both groups. Rapid ventricular pacing did not affect catecholamine levels before propranolol, but after propra...Continue Reading

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Citations

Aug 24, 1999·Pacing and Clinical Electrophysiology : PACE·K YlitaloK Peuhkurinen
Jun 29, 2000·Scandinavian Cardiovascular Journal : SCJ·K Ylitalo, K Peuhkurinen

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