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Mechanisms of Myocardial Infarct Prevention with β-Adrenoceptor Blocking Drugs

  • Section 7: Myocardial Infarction
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Summary

There are several mechanisms that are potentially of importance in the use of β-adrenoceptor blocking drugs in the prevention and treatment of myocardial infarction.

Inhibition of sympathetic stimulation of the heart reduces myocardial oxygen consumption. β-Blockers without partial agonist activity alter cardiac dynamics at rest, and all β-blockers inhibit the effects of sympathetic induced tachycardia on exercise and following various types of physiological stress. Besides potential overall improvement in oxygen supply-to-use ratio, there is evidence to suggest that β-blockers alter the distribution of myocardial blood flow so more blood is diverted towards ischaemic areas. An improvement in oxygenation will reverse the arrhythmogenic effect of anoxia. β-Blockers also have an anti-arrhythmic effect on pacemaker cells, perhaps particularly against the excess catecholamines released in myocardial ischaemia.

There are several other actions of β-blockers that may be relevant: they improve metabolism of the ischaemic myocardium, they reverse the abnormal sensitivity of platelet aggregation that has been reported in ischaemic patients, and they shift the oxygen dissociation curve to the right and so improve tissue delivery of oxygen.

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    B. N. C. Prichard

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Prichard, B.N.C. Mechanisms of Myocardial Infarct Prevention with β-Adrenoceptor Blocking Drugs. Drugs 25 (Suppl 2), 295–302 (1983). https://doi.org/10.2165/00003495-198300252-00089

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