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Mechanism of Action of Adrenergic Agents in Acute Congestive Heart Failure

  • G. A. Kopia
  • R. R. Ruffolo
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 6)

Abstract

β 1 - and β 2 -Adrenoceptor Activation : The subclassification of catecholamine-mediated cardiovascular responses into α and β was originally proposed by Ahlquist [1] who was first to demonstrate that the in vivo actions of adrenaline, noradrenaline and isoprenaline could be explained most simply by the presence of two adrenoceptor subtypes; the first, α, which mediates vasoconstriction, uterine and ureter smooth muscle excitation, nictitating membrane contraction and inhibition of intestinal motility. The second adrenoceptor subtype, β mediates vasodilation, uterine relaxation and myocardial activation. Later work by Lands et al. [2, 3] further subdivided the β-adrenoceptor-mediated cardiovascular responses into β1, characterized by increases in myocardial rate and force of contraction and lipolysis, and β2 which mediates vascular and pulmonary smooth muscle relaxation. While this work was seminal in our understanding of the actions and functions of the sympathetic nervous system, it also resulted in the identification of a specific therapeutic target, the β-adrenoceptor, for pharmacologic intervention in states of myocardial insufficiency. β1-Adrenoceptor activation has long been known to mediate increases in chronotropic and inotropic state. More recent studies have demonstrated the presence of β2-adrenoceptors in cardiac tissue which also mediate positive chronotropic and inotropic responses [4, 5], such that stimulation of both β-adrenoceptor subtypes has the capacity to increase the rate and force of cardiac contraction, thereby improving cardiac output and tissue perfusion. The increases in cardiac rate and force of contraction evoked by activation of myocardial β1- and β2-adrenoceptors result from the activation of adenylate cyclase and the subsequent accumulation of cyclic AMP.

Keywords

Congestive Heart Failure Partial Agonist Chronic Congestive Heart Failure Inotropic Response Adrenergic Agent 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Ahlquist RP (1948) A study of the adrenotropic receptors. Am J Physiol 153:586–600PubMedGoogle Scholar
  2. 2.
    Lands AM, Arnold A, McAuliff JP, Luduena FP, Brown TG (1967) Differentiation of receptor systems activated by sympathetic amines. Nature 214:597–598PubMedCrossRefGoogle Scholar
  3. 3.
    Lands AM, Luduena FP, Buzzo HJ (1967) Differentiation of receptors responsive to isoproterenol. Life Sci 6:2241–2249PubMedCrossRefGoogle Scholar
  4. 4.
    Bristow MR, Ginsburg R (1986) Beta-2 receptors on myocardial cells in human ventricular myocardium. Am J Cardiol 57:3F–6FPubMedCrossRefGoogle Scholar
  5. 5.
    Bristow MR, Ginsburg R, Umans V et al (1986) Beta-1 and beta-2 adrenergic-receptor sub-populations in nonfailing and failing human ventricular myocardium: coupling of both receptor subtypes to muscle contraction and selective beta-1 receptor down-regulation in heart failure. Circ Res 59:297–309PubMedGoogle Scholar
  6. 6.
    Broadley KJ (1982) Cardiac adrenoreceptors. J Auton Pharmacol 2:119–145CrossRefGoogle Scholar
  7. 7.
    Govier WC (1967) Prolongation of the myocardial functional refractory period by phenylephrine. Life Sci 6:1367–1371PubMedCrossRefGoogle Scholar
  8. 8.
    Osnes J-B (1976) Positive inotropic effect without cyclic AMP elevation after α-adrenergic stimulation of perfused hearts from hypothyroid rats. Acta Pharmacol Toxicol 39:232–240CrossRefGoogle Scholar
  9. 9.
    Schuman HJ, Brodde OE (1979) Demonstration of a-adrenoceptor in the rabbit heart by 3H-dihydroergocryptine binding. Naunyn-Schmeideberg’s Arch Pharmacol 308:191–198CrossRefGoogle Scholar
  10. 10.
    Schuman HJ, Endoh M (1976) Alpha-adrenoceptors in the ventricular myocardium: clonidine, naphazoline and methoxamine as partial alpha agonists exerting a competitive dualism in action to phenylephrine. Eur J Pharmacol 36:413–421CrossRefGoogle Scholar
  11. 11.
    Hoffman BB, Lefkowitz RJ (1980) Radioligand binding studies of adrenergic receptors: New insights into molecular and physiological regulation. Ann Rev Pharmacol Toxicol 20:581–608CrossRefGoogle Scholar
  12. 12.
    Raisman R, Briley M, Langer SZ (1979) Specific labelling of postsynaptic α1-adrenoceptors in rat heart ventricle by 3H-WB-4101. Naunyn-Schmiedeberg’s Arch Pharmacol 307:223–226CrossRefGoogle Scholar
  13. 13.
    Brodde OE, Motomura S, Endoh M, Schumann HJ (1978) Lack of correlation between the positive inotropic effect evoked by alpha-adrenoceptor stimulation and the levels of cyclic AMP and/or cyclic GMP in the isolated ventricle strip of the rabbit. J Mol Cell Cardiol 10:207–219PubMedCrossRefGoogle Scholar
  14. 14.
    Schuman HJ, Endoh M, Brodde OE (1975) The time course of the effects of beta-and alpha-adrenoceptor stimulation by isoprenaline and methoxamine on the contractile force and cAMP level of the isolated rabbit papillary muscle. Naunyn-Schmiedeberg’s Arch Pharmacol 289:291–302CrossRefGoogle Scholar
  15. 15.
    Miller RR, Awan NA, Maxwell KS, Mason DT (1977) Sustained reduction of cardiac impedance and preload in congestive heart failure with the antihypertensive vasodilator prazosin. N Engl J Med 297:303–307PubMedCrossRefGoogle Scholar
  16. 16.
    Dazu VJ, Colucci WS, Williams GH, Curfman G, Meggs L, Hollenberg NK (1980) Sustained effectiveness of converting-enzyme inhibition in patients with severe congestive heart failure. N Engl J Med 302:1373–1379CrossRefGoogle Scholar
  17. 17.
    Colucci WS, Wynne J, Holman BL, Braunwald E (1980) Long-term therapy of heart failure with prazosin: a randomized double-blind trial. Am J Cardiol 45:337–344PubMedCrossRefGoogle Scholar
  18. 18.
    Pierpont GL, Cohn JN, Franciosa JA (1978) Combined oral hydralazine-nitrate therapy in left ventricular failure: hemodynamic equivalency to sodium nitroprusside. Chest 73:8–13PubMedCrossRefGoogle Scholar
  19. 19.
    Cohn JN, Archibald DG, Ziesche S, Franciosa JA, et al (1986) Effect of vasodilator therapy on mortality in chronic congestive heart failure: results of a veterans administration cooperative study. N Engl J Med 314:1547–1552PubMedCrossRefGoogle Scholar
  20. 20.
    Keeton TK, Campbell WB (1980) The pharmacologic alteration of renin release. Pharmacol Rev 32:81–227PubMedGoogle Scholar
  21. 21.
    Ruffolo RR Jr (1983) Drug, neurotransmitter and hormone receptors in the regulation of the cardiovascular system. In: Shoemaker WCX, Thompson WC (eds) Critical care state-of-the-art. Society of Critical Care Medicine, pp K1–K56Google Scholar
  22. 22.
    Cohn JN, Levin TB, Olivari MT, et al (1984) Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 311:819–823PubMedCrossRefGoogle Scholar
  23. 23.
    Fennel WH, Taylor AA, Young JB et al (1981) Activation of presynaptic dopamine receptors in man: a new mechanism for afterload reduction. Clin Res 29:271AGoogle Scholar
  24. 24.
    Rajfer SI, Anton AH, Rossen JD, Goldberg LI (1984) Beneficial hemodynamic effects of oral levodopa in heart failure: relation to the generation of dopamine. N Engl J Med 310:1357–1362PubMedCrossRefGoogle Scholar
  25. 25.
    Bristow MR, Ginsburg R, Minobe W, et al (1982) Decreased catecholamine sensitivity and beta-adrenergic-receptor density in failing human hearts. N Engl J Med 307:205–211PubMedCrossRefGoogle Scholar
  26. 26.
    Bristow MR, Ginsburg R, Minobe WA, Harrison DC, Reitz BA, Stinson EB (1982) Betaadrenergic receptor measurements in normal failing human right and left ventricle (abstr). Circulation 66 (Suppl II):207Google Scholar
  27. 27.
    Bristow MR, Laser JA, Minobe W, Ginsburg R, Fowler MB, Rasmussen R (1984) Selective down-regulatin of beta1-adrenergic receptors in the failing human heart (abstr). Circulation 70 (Suppl II):67Google Scholar
  28. 28.
    Laser JA, Bristow MR, Minobe WA, Fowler MB (1984) Beta-adrenergic receptor binding in human endomyocardial biopsy tissue (abstr). J Am Coll Cardiol 3:566Google Scholar
  29. 29.
    Baumann G, Mercader D, Busch U, et al (1983) Effects of the H2-receptor antagonist impromidine in human myocardium from patients with heart failure due to mitral and aortic value disease. J Cardiovasc Pharmacol 5:618–625PubMedCrossRefGoogle Scholar
  30. 30.
    Ginsburg R, Esserman U, Bristow MR (1983) Myocardial performance and extracellular ionized calcium in a severely failing human heart. Ann Intern Med 98:603–606PubMedGoogle Scholar
  31. 31.
    Fowler MB, Bristow MR, Hopkins DG, et al (1984) Impaired beta-adrenergic inotropic response in severe heart failure. Circulation 70 (Suppl II):191Google Scholar
  32. 32.
    Hedberg A, Kemp FC, Goldstein PE, Josephson ME, Molinoff PB (1983) Regulation of beta,-and beta2-adrenergic receptors in human atria (abstr). Circulation 68(Suppl III):99Google Scholar
  33. 33.
    Karliner JS, Barnes P, Brown M, Dollery C (1980) Chronic heart failure in the guinea pig increases cardiac alpha1- and beta-adrenoceptors. Eur J Pharmacol 67:115–118PubMedCrossRefGoogle Scholar
  34. 34.
    Chang HY, Klein PM, Kunos G (1982) Selective densensitization of cardiac beta receptors by prolonged in vivo infusion of catecholamines in rats. J Pharmacol Exp Ther 221:784–789PubMedGoogle Scholar
  35. 35.
    Ariens EJ (1981) The classification of beta-adrenoceptors. Trends Pharmacol Sci 2:170–172CrossRefGoogle Scholar
  36. 36.
    Unverferth DV, Blanford M, Kates RE, Leier CV (1980) Tolerance to dobutamine after a 72-hour continuous infusion. Am J Med 69:262–266PubMedCrossRefGoogle Scholar
  37. 37.
    Ruffolo RR Jr (1982) Important concepts of receptor theory. J Auton Pharmacol 2:277–295PubMedCrossRefGoogle Scholar
  38. 38.
    Kenakin TP, Ferris RM (1983) Effects of in vivo beta-adrenoceptor down-regulation on cardiac responses to prenalterol and pirbuterol. J Cardiovasc Pharmacol 5:90–97PubMedCrossRefGoogle Scholar
  39. 39.
    Colucci WS, Alexander RW, Mudge GH, et al (1981) Acute and chronic effects of pirbuterol on left ventricular ejection fraction and clinical status in severe congestive heart failure. Am Heart J 102:564–568PubMedCrossRefGoogle Scholar
  40. 40.
    Endoh M (1983) Inhibition of the positive inotropic effect of dopamine by YM-09538 with α -and ß-adrenoceptor antagonist action in the rabbit papillary muscle. Jpn J Pharmacol 33:897–899PubMedCrossRefGoogle Scholar
  41. 41.
    Ruffolo RR Jr (1987) Review: The pharmacology of dobutamine. Am J Med Sciences 30:244–248CrossRefGoogle Scholar
  42. 42.
    Hayes JS, Bowling N, Pollock GD (1985) Effects of beta-adrenoceptor down-regulation on the cardiovascular responses to the enantiomers of dobutamine. J Pharmacol Exp Ther 235:58–65PubMedGoogle Scholar
  43. 43.
    Leier CV, Heban P, Huss P, Bush CA, Lewis RP (1978) Comparative systemic and regional hemodynamic effects of dopamine and dobutamine in patients with cardiomyopathic heart failure. Circulation 58:466–475PubMedGoogle Scholar
  44. 44.
    Sonnenblick EH, Frishman WH, LeJemtel TH (1979) Dobutamine: a new synthetic cardioactive sympathetic amine. N Engl J Med 300:17–22PubMedCrossRefGoogle Scholar
  45. 45.
    Ruffolo RR Jr, Spradlin TA, Pollock GD, Waddell JE, Murphy PJ (1981) A-and ß-adrenergic effects of the stereoisomers of dobutamine. J Pharmacol Exp Ther 219:447–452PubMedGoogle Scholar
  46. 46.
    Kenakin TP (1981) An in vitro quantitative analysis of the a-adrenoceptor partial agonist activity of dobutamine and its relevance to inotropic selectivity. J Pharmacol Exp Ther 216:210–219PubMedGoogle Scholar
  47. 47.
    Ruffolo RR Jr, Messick K (1985) Systemic hemodynamic effects of dopamine, (±)-dobutamine and (±)- and (-)-enantiomers of dobutamine in anesthetized normotensive rats. Eur J Pharmacol 109:173–181PubMedCrossRefGoogle Scholar
  48. 48a.
    Ruffolo RR Jr, Yaden EL (1983) Vascular effects of stereoisomers of dobutamine. J Pharmacol Exp Ther 224:46–50PubMedGoogle Scholar
  49. 48b.
    Maccarrone C, Malta E, Raper C (1984) Beta-adrenoceptor selectivity of dobutamine: in vivo and in vitro studies. J Cardiol Pharmacol 6:132–141CrossRefGoogle Scholar
  50. 49.
    Goldberg LI, Rajfer SI (1985) Dopamine receptors: applications in clinical cardiology. Circulation 72:245–248PubMedCrossRefGoogle Scholar
  51. 50.
    Weinstock J, Wilson JW, Ladd DL, et al (1980) Separation of potent central and renal dopamine agonist activity in substituted 6-chloro-2,3,4,5-tetrahydro-7,8-dihydroxy-l-phenyl-1H-3-benzazepines. J Med Chem 23:973–975PubMedCrossRefGoogle Scholar
  52. 51.
    Hahn RA, Wardell JR, Sarau HM, Ridley PT (1982) Characterization of the peripheral and central effects of SK&F 82526, a novel dopamine receptor agonist. J Pharmacol Exp Ther 223:305–313PubMedGoogle Scholar
  53. 52.
    Foley JJ, Sarau HM (1984) Adrenergic binding studies of SK&F-82 526 and its enantiomers. Fed Proc 43:555 (abst)Google Scholar
  54. 53.
    Ohlstein EH, Zabko-Potapovich B, Berkowitz BA (1985) The DA-1 receptor agonist fenoldopam (SK&F 82526) is also an alpha-2-adrenoceptor antagonist. Eur J Pharmacol 118:321–329PubMedCrossRefGoogle Scholar
  55. 54.
    Nakamura S, Kohli JD, Rajfer SI (1986) Alpha-adrenoceptor blocking activity of fenoldopam (SK&F 82526), a selective DA-1 agonist. J Pharm Pharmacol 38:113–117PubMedCrossRefGoogle Scholar
  56. 55.
    Young JB, Leon CA, Pratt CM, Suarez JM, Aronoff RD, Roberts R (1985) Hemodynamic effects of an oral dopamine receptor agonist (fenoldopam) in patients with congestive heart failure. J Am Coll Cardiol 6:792–796PubMedCrossRefGoogle Scholar
  57. 56.
    King BD, Beck TR, Snyder MM, Musser TK (1987) Efficacy of fenoldopam (SKF 82526) in chronic congestive heart failure. Circulation 76: IV-71 (abst)Google Scholar
  58. 57.
    Dawson JR, Thompson DS, Signy M, et al (1985) Acute haemodynamic and metabolic effects of dopexamine, a new dopaminergic receptor agonist, in patients with chronic heart failure. Br Heart J 54:313–320PubMedCrossRefGoogle Scholar
  59. 58.
    Jaski BE, Wijins W, Foulds R, Serruys PW (1986) The haemodynamic and myocardial effects of dopamine: a new beta-2-adrenoceptor and dopaminergic agonist. Br J Clin Pharmacol 21:393–400PubMedGoogle Scholar
  60. 59.
    Svensson G, Sjogren A, Erhardt L (1986) Short-term haemodynamic effects of dopexamine in patients with chronic congestive heart failure. Eur Heart J 7:697–703PubMedGoogle Scholar
  61. 60.
    Bayliss J, Thomas L, Poole-Wilson P (1987) Acute hemodynamic and neuroendocrine effects of dopexamine, a new vasodilator for the treatment of heart failure: comparison with dobutamine, captopril, and nitrate. J Cardiovasc Pharmacol 9:551–554PubMedCrossRefGoogle Scholar
  62. 61.
    Tan LB, Smith SA, Murray RG, Littler WA (1986) Renal response to dopexamine infusion in low output heart failure. Clin Sci 71: (suppl 15): 56P (abst)Google Scholar
  63. 62.
    O’Donnell SR (1970) A selective beta-adrenoceptor stimulant (Th1165a) related to orciprenaline. Eur J Pharmacol 12:35–43PubMedCrossRefGoogle Scholar
  64. 63.
    Mugge A, Posselt D, Reimer U, Schmitz W, Scholz H (1985) Effects of the beta-2-adrenoceptor agonists fenoterol and salbutamol on force for contraction in isolated human ventricular myocardium. Klin Wochenschr 63:26–31PubMedCrossRefGoogle Scholar
  65. 64.
    Lichtlen V-P, Stutz R (1969) Hämodynamische Untersuchungen mit dem p-Hydroxyphenylderivat des Orciprenalins. Arzneim Forsch 19:147–149Google Scholar
  66. 65.
    Gattiker H, Rothlin M (1971) Vergleich der Wirkungen des neuen Sympathicomimeticums TH1165a mit jenen von Isoprenalin auf den Kreislauf herzoperierter Patienten. Arzneim Forsch 21:1191–1194Google Scholar
  67. 66.
    Inner M, Wollschlager H, Just H (1981) Behandlung der schweren Herzinsuffizienz mit dem beta-Stimulator Fenoterol. Klin Wochenschr 59:639–645CrossRefGoogle Scholar
  68. 67.
    Moore PF, Constantine JW, Barth WE (1978) Pirbuterol, a selective beta-2 adrenergic bronchodilator. J Pharmacol Exp Ther 207:410–418PubMedGoogle Scholar
  69. 68.
    Smiseth OA (1983) Effects of the beta-adrenergic receptor agonist pirbuterol on cardiac performance during acute ischaemic left ventricular failure in dogs. Eur J Pharmacol 87:379–386PubMedCrossRefGoogle Scholar
  70. 69.
    Bourdillon PVD, Dawson JR, Foale RA, et al (1980) Salbutamol in treatment of heart failure. Br Heart J 43:206–210PubMedCrossRefGoogle Scholar
  71. 70.
    Timmis AD, Fowler MB, Chamberlain DA (1981) Comparison of haemodynamic responses to dopamine and salbutamol in severe cardiogenic shock complicating acute myocardial infarction. Br Med J 282:7–9CrossRefGoogle Scholar
  72. 71.
    Sharma B, Goodwin JF (1978) Beneficial effect of salbutamol on cardiac function in severe congestive cardiomyopathy: effect on systolic and diastolic function of the left ventricle. Circulation 58:449–460PubMedGoogle Scholar
  73. 72.
    Dawson JR, Canepa-Anson R, Kuan P, et al (1981) Treatment of chronic heart failure with pirbuterol: acute haemodynamic responses. Br Med J 282:1423–1426CrossRefGoogle Scholar
  74. 73.
    Awan NA, Evenson MK, Needham KE, et al (1981) Hemodynamic effects of oral pirbuterol in chronic severe congestive heart failure. Circulation 63:96–101.PubMedCrossRefGoogle Scholar
  75. 74.
    Sharma B, Hoback J, Francis GS, et al (1981) Pirbuterol: a new sympathomimetic amine for the treatment of congestive heart failure. Am Heart J 102:533–541PubMedCrossRefGoogle Scholar
  76. 75.
    Carlsson I, Dahlof C, Hedberg A, Persson H, Tangstrand P (1977) Differentiation of cardiac chronotropic and inotropic effects of beta-adrenoceptor agonists. Naunyn-Schmeideberg’s Arch Pharmacol 300:101–105CrossRefGoogle Scholar
  77. 76.
    Rohm N, Wagner J, Schuman HJ (1980) The lack of a pronounced preference of prenalterol for the beta-l-adrenoceptor subtype. Naunyn-Schmeideberg’s Arch Pharmacol 315:85–88CrossRefGoogle Scholar
  78. 77.
    Minneman KP, Hedberg A, Molinoff PB (1979) Comparison of beta adrenergic receptor subtypes in mammalian tissues. J Pharmacol Exp Ther 211:502–508PubMedGoogle Scholar
  79. 78.
    Hedberg A, Mattsson H, Carlsson E (1980) Prenaterol, a non-selective beta-adrenoceptor ligand with absolute beta-1-selective partial agonist activity. J Pharm Pharmacol 32:660–661PubMedCrossRefGoogle Scholar
  80. 79.
    Ariniego R, Waagstein F, Mombay B, Hjalmarson A (1979) Haemodynamic effects of a new beta-l-receptor agonist in acute myocardial infarction: a useful antidote to unwanted cardiac effects of beta-blocking agents. Br Heart J 42:139–146PubMedCrossRefGoogle Scholar
  81. 80.
    Hutton I, Murray RG, Boyes RN, Rae AP, Hillis WS (1980) Haemodynamic effects of prenalterol in patients with coronary heart disease. Br Heart J 43:134–137PubMedCrossRefGoogle Scholar
  82. 81.
    Branzi A, Binetti G, Specchia C, Magelli C, Zannoli R, Magnani B (1983) Haemodynamic effects of prenalterol in acute myocardial ischaemia in open chest pigs. Clin Exp Pharmacol Physiol 10:219–227PubMedCrossRefGoogle Scholar
  83. 82.
    Kirlin PC, Pitt B, Lucchesi BR (1981) Comparative effects of prenalterol and dobutamine in a canine model of acute ischemic heart failure. J Cardiovasc Pharmacol 3:896–905PubMedCrossRefGoogle Scholar
  84. 83.
    Jennings G, Bobik A, Oddie C, Hargreaves M, Korner P (1983) Cardioselectivity of prenalterol and isoproterenol. Clin Pharmacol Ther 34:749–757PubMedCrossRefGoogle Scholar
  85. 84.
    Erbel P, Meyer J, Schweizer P, et al (1982) Haemodynamic effects of prenalterol in patients with severe congestive heart failure-NYHA III-IV. Acta Med Scand 212 (suppl 659):169–180Google Scholar
  86. 85.
    Hjalmarson A, Abelardo N, Caidahl K, et al (1982) Effects of prenalterol administered orally in patients with congestive heart failure. Acta Med Scand 212 (suppl 659):201–220Google Scholar
  87. 86.
    Waagstein F, Estrada-Yamamoto M, Reiz S, et al (1982) Haemodynamic effects of intravenously administered prenalterol in patients with severe heart failure. Acta Med Scand 212 (suppl 659):221–231Google Scholar
  88. 87.
    Guazzi MD, Quing LG, Olivari MT, et al (1982) Circulatory response to prenalterol in normal subjects and in patients with primary congestive cardiomyopathy. Acta Med Scand 212 (suppl 659):233–250Google Scholar
  89. 88.
    Awan NA, Evenson MK, Needham KE, Mason DT (1982) The hemodynamic action of prenalterol in left ventricular failure. Acta Med Scand 212 (suppl 659):251–261Google Scholar
  90. 89.
    Nuttall A, Snow HM (1982) The cardiovascular effects of ICI 118, 587: a beta-l-adrenoceptor partial agonist. Br J Pharmacol 77:381–388PubMedGoogle Scholar
  91. 90.
    Malta E, Mian MA, Raper C (1985) The in vitro pharmacology of xamoterol (ICI 118,587). Br J Pharmacol 85:179–187PubMedGoogle Scholar
  92. 91.
    Pouleur H, Mechelen H, Balasim H, Rousseau MF, Charlier AA (1984) Comparison of the inotropic effects of the beta-1-adrenoceptor partial agonists SL 75.177.10 and ICI 118,587 with digoxin on the intact canine heart. J Cardiovasc Pharmacol 6:720–726PubMedCrossRefGoogle Scholar
  93. 92.
    Hashimoto T, Shiina A, Toyo-Oka T, Hosoda S, Kondo K (1986) The cardiovascular effects of xamoterol, a beta-1-adrenoceptor partial agonist, in healthy volunteers at rest. Br J Clin Pharmacol 21:259–265PubMedGoogle Scholar
  94. 93.
    Jennings G, Bobik A, Oddie C, Restall R (1984) Cardioselectivity, kinetics, hemodynamics, and metabolic effects of xamoterol. Clin Pharmacol Ther 35:594–603PubMedCrossRefGoogle Scholar
  95. 94.
    Sato H, Inoue M, Matsuyama T, et al (1987) Hemodynamic effects of the beta-l-adrenoceptor partial agonist xamoterol in relation to the plasma norepinephrine levels during exercise in patients with left ventricular dysfunction. Circulation 75:213–220PubMedCrossRefGoogle Scholar
  96. 95.
    Rousseau MF, Pouleur H, Vincent M (1983) Effects of a cardioselective beta-1 partial agonist (corwin) on left ventricular function and myocardial metabolism in patients with previous myocardial infarction. Am J Cardiol 51:1267–1274PubMedCrossRefGoogle Scholar
  97. 96.
    Franciosa JA, Marlow HF (1987) Clinical efficacy of xamoterol (corwin) compared to placebo in heart failure. Circulation 76:IV-87 (abst)Google Scholar
  98. 97.
    Vigholt E, Faergeman O, Snow HM (1987) Effects of xamoterol (beta-1 adrenoceptor partial agonist) in patients with mild to moderate heart failure. Circulation 76:IV-87 (abst)Google Scholar
  99. 98.
    Colucci WS (1982) Alpha-adrenergic receptor blockade with prazosin. Ann Intern Med 97:67–77PubMedGoogle Scholar
  100. 99.
    Stanaszek WF, Kellerman D, Brogden RN, Romankiewicz JA (1983) Prazosin update: A review of its pharmacological properties and therapeutic use in hypertension and congestive heart failure. Drugs 25:339–384PubMedCrossRefGoogle Scholar
  101. 100.
    Lemke R, Trompler A, Kaltenbach M, Bussman WD (1979) Wirkung von Prazosin bei der therapierefraktaren chronis chem. Herzinsuffizienz. Dtsch Med Wochenschr 104:1769–1773PubMedCrossRefGoogle Scholar
  102. 101.
    Bertel O, Burkart F, Buhler FR (1981) Sustained effectiveness of chronic prazosin therapy in severe chronic congestive heart failure. Am Heart J 101:529–533PubMedCrossRefGoogle Scholar
  103. 102.
    Feldman RC, Ball RM, Winchester MA, Jaillon P, Kates RE, Harrison DC (1981) Beneficial hemodynamic response to chronic prazosin therapy in congestive heart failure. Am Heart J 101:534–540PubMedCrossRefGoogle Scholar
  104. 103.
    Higginbotham MB, Morris KG, Bramlet DA, Coleman RE, Cobb FR (1983) Long-term ambulatory therapy with prazosin versus placebo for chronic heart failure: Relation between clinical response and left ventricular function at rest and during exercise. Am J Cardiol 52:782–788PubMedCrossRefGoogle Scholar
  105. 104.
    Rubin SA, Chatterjee K, Geldberg HJM, Ports TA, Brundage BH, Parmley WW (1979) Paradox of improved exercise but not resting hemodynamics with short-term prazosin in congestive heart failure. Am J Cardiol 43:810–815PubMedCrossRefGoogle Scholar
  106. 105.
    Thomas JA, Marks BH (1978) Plasma norepinephrine in congestive heart failure. Am J Cardiol 41:233–243PubMedCrossRefGoogle Scholar
  107. 106.
    Ogasawara B, Ogawa K, Hayashi H, Sassa H (1981) Plasma renin activity and plasma concentration of norepinephrine and cyclic nucleotides in heart failure after prazosin. Clin Pharmacol Ther 29:464–471PubMedCrossRefGoogle Scholar
  108. 107.
    Kelly DT, Delago CE, Taylor DT, Pitt B, Ross RS (1973) Use of phentolamine in acute myocardial infarction associated with hypertension and left ventricular failure. Circulation 47:729–735PubMedGoogle Scholar
  109. 108.
    Walinsky P, Chatterjee K, Forrester J, Parmley WW, Swan HJ (1974) Enhanced left ventricular performance with phentolamine in acute myocardial infarction. Am J Cardiol 33:37–41PubMedCrossRefGoogle Scholar
  110. 109.
    Perret CL, Gardez JP, Reynaert M (1975) Phentolamine for vasodilator therapy in left ventricular failure complicating acute myocardial infarction. Br Heart J 37:640–646PubMedCrossRefGoogle Scholar
  111. 110.
    Engelmeier RS, O’Connell JB, Walsh R, Rad N, Scanlon PJ, Gunnar RM (1985) Improvement in symptoms and exercise tolerance by metoprolol in patients with dilated cardiomyopathy: a double-blind, randomized, placebo-controlled trial. Circulation 72:536–546PubMedCrossRefGoogle Scholar
  112. 111.
    Heilbrunn SM, Shah P, Valentine HA, et al (1986) Increased beta-receptor density and improved hemodynamic response to catecholamine stimulation during chronic metoprolol therapy. Circulation 74:II-310 (abst)Google Scholar
  113. 112.
    Swedberg K, Hjalmarson A, Waagstein F, Wallentin I (1980) Beneficial effects of longterm beta-blockade in congestive cardiomyopathy. Br Heart J 44:117–133PubMedCrossRefGoogle Scholar
  114. 113.
    Anderson JL, Lutz JR, Gilbert EM, et al (1985) A randomized trial of low-dose beta-blockade therapy for idiopathic cardiomyopathy. Am J Cardiol 55:471–475PubMedCrossRefGoogle Scholar
  115. 114.
    Chadda K, Goldstein S, Byington R, Curb JD (1986) Effect of propranolol after acute myocardial infarction in patients with congestive heart failure. Circulation 73:503–510PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • G. A. Kopia
  • R. R. Ruffolo

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