Protection of ischemic myocardium: comparison of effects of propranolol, bevantolol and N-dimethyl propranolol on infarct size following coronary artery occlusion in anesthetized dogs.

The relative extent of myocardial infarction produced by occlusion of the left anterior descendens coronary artery in anesthetized dogs was determined under control conditions or following treatment (4 h after ligation) with propranolol (1 mg/kg), bevantolol (3 mg/kg) or N-dimethyl propranolol (10 mg/kg). Doses of drugs were selected to provide similar reductions in heart rate, aortic blood pressure and contractility. Infarct size was estimated indirectly from levels of plasma creatine phosphokinase and measured histochemically by nitroblue tetrazolium stain. A significant ( p < 0.001) correlation between methods was found. Propranolol and bevantolol (beta adrenergic antagonists) produced a significant (p < 0.05) reduction (approximately 50% decrease) in infarct size, measured at 8 h following induction of ischemia, while N-dimemthyl propranolol (no beta antagonist activity) produced no effect. While all three agents produced similar hemodynamic actions and thereby reduced primary determinants of myocardial oxygen demand, only the beta blockers were able to afford protection of ischemic myocardium.