This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kirshenbaum, J. M. Articles by Braunwald, E. Search for Related Content PubMed PubMed Citation Articles by Kirshenbaum, J. M. Articles by Braunwald, E.

Circulation, Vol 72, 873-880, Copyright © 1985 by American Heart Association

ARTICLES

Use of an ultra short-acting beta-blocker in patients with acute myocardial ischemia

JM Kirshenbaum, RA Kloner, EM Antman and E Braunwald

Esmolol is a new ultra short-acting (half-life [t1/2] beta 9 min) beta 1-adrenergic-receptor antagonist reported to have no intrinsic sympathomimetic activity. The safety and efficacy of esmolol in lowering the ventricular rate and rate-pressure product in patients with acute myocardial infarction (n = 5), postmyocardial infarction angina (n = 10), or acute unstable angina (n = 4), and without cardiogenic shock were studied. After a 30 min observation period, esmolol was titrated to a maximum dose of 300 micrograms/kg/min and infused for up to 420 min. The ventricular rate fell from 92 +/- 11 (mean +/- SD) to 77 +/- 13 beats/min (p less than .01) and the systolic arterial pressure decreased from 120 +/- 13 to 97 +/- 11 mm Hg (p less than .01) during the initial 30 min titration period. There was no significant change during the maintenance phase, and both the ventricular rate and arterial pressure returned rapidly toward baseline values within 30 min of termination of the infusion. The cardiac index fell from 2.8 +/- 0.6 to 2.2 +/- 0.6 liters/min/m2 (p less than .01) during the same period, and also returned to the baseline level 30 min after termination of the infusion. There was no significant change in the pulmonary capillary wedge pressure, respiratory rate, or PR interval. Five patients required termination of infusion because of hypotension and all recovered uneventfully within 30 min of stopping the esmolol. One patient required a brief infusion of dopamine to restore hemodynamic stability.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				A. A. Alsaddique, A. G. Royse, C. F. Royse, and M. A. Fouda Management of diastolic heart failure following cardiac surgery Eur. J. Cardiothorac. Surg., February 1, 2009; 35(2): 241 - 249. [Abstract] [Full Text] [PDF]

				G. W. Laub, S. Muralidharan, J. Reibman, J. Fernandez, W. A. Anderson, J. Gu, C. Daloisio, L. B. McGrath, and L. J. Mulligan ESMOLOL AND PERCUTANEOUS CARDIOPULMONARY BYPASS ENHANCE MYOCARDIAL SALVAGE DURING ISCHEMIA IN A DOG MODEL J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1085 - 1091. [Abstract] [Full Text]