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(Chest. 1973;64:619-627.)
© 1973 American College of Chest Physicians

Comparison of Relative Inotropic and Chronotropic Effects of Propranolol, Practolol, and Sotalol

Robert E. Goldstein M.D.1; Clifford A. Hall M.D.1; and Stephen E. Epstein M.D.1

1 Cardiology Branch, National Heart and Lung Institute, Bethesda, Md.

Several studies comparing beta receptor blocking agents have raised the possibility that practolol or sotalol may act more selectively on beta receptors affecting heart rate than on beta receptors influencing contractility. To further evaluate this potentially important hypothesis, the relative effects of practolol, sotalol and propranolol on heart rate and contractile force were measured in thoracotomized dogs. Animals receiving substantial beta receptor stimulation manifested a dose-related reduction in both heart rate and contractile force after treatment with all three drugs. Furthermore, dosages of each drug matched to produce equal decreases in heart rate also caused equal decrements in contractile force. In contrast, dogs devoid of beta receptor stimulation due to prior administration of reserpine and adrenalectomy responded to practolol with a dose-related increase in contractile force (maximum 22 percent) and in heart rate. Effective beta-blocking doses of propranolol (up to 0.64 mg/kg) caused neither stimulatory nor depressant effects in reserpinized-adrenalectomized preparations. Thus, practolol differs from propranolol in that it exerts a positive inotropic influence, detectable when beta stimulation is absent. Nevertheless, such an effect is inapparent if beta stimulation is sub-statial, which is often true when beta blockade is used clinically. Neither practolol nor sotalol, as used therapeutically, appear to act on heart rate more selectively than propranolol.




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