COMPARATIVE HEMODYNAMIC-EFFECTS OF AMIODARONE, SOTALOL, AND D-SOTALOL

Citation
N. Twidale et al., COMPARATIVE HEMODYNAMIC-EFFECTS OF AMIODARONE, SOTALOL, AND D-SOTALOL, The American heart journal, 126(1), 1993, pp. 122-129
Citations number
53
Categorie Soggetti
Cardiac & Cardiovascular System
Journal title
ISSN journal
00028703
Volume
126
Issue
1
Year of publication
1993
Pages
122 - 129
Database
ISI
SICI code
0002-8703(1993)126:1<122:CHOASA>2.0.ZU;2-9
Abstract
The effects of intravenous boluses of amiodarone (5 mg/kg), racemic so talol (enantiomeric ratio d/l-sotalol 1:1;1.5 mg/kg), and d-sotalol (0 .75 mg/kg) on mean arterial pressure (MAP), heart rate (HR), cardiac o utput (CO), total peripheral resistance (TPR), left ventricular end-di astolic pressure (LVEDP), and peak rate of change of left ventricular pressure (LV dp/dt) were assessed in conscious rabbits. Amiodarone and sotalol had a modest negative inotropic effect: amiodarone reduced pe ak LV dp/dt by 8 +/- 2% (mean +/- SEM) (p < 0.05) and sotalol by 6 +/- 2% (p < 0.05). These two drugs had quite different effects on CO as a result of differences in their actions on peripheral blood vessels: a miodarone caused a 13 +/- 3% (p < 0.05) increase in CO associated with a substantial vasodilatory effect (TPR reduced 25 +/- 3%; p < 0.01); sotalol did not produce any substantial change in either CO or TPR. Bo lus intravenous injection of amiodarone was associated with a signific ant increase in HR (12 +/- 3%; p < 0.01), whereas sotalol reduced HR b y 7 +/- 1 % (p < 0.05). In contrast, administration of the dextro-rota tory optical isomer, d-sotalol, produced no significant change in peak LV dp/dt, LVEDP, CO, TPR, or HR. These results confirm that amiodaron e and racemic sotalol have a comparatively weak cardiodepressant actio n. The experiments also show that the reduction in cardiac performance associated with racemic sotalol is mediated predominantly through the beta-adrenoreceptor blocking action of the levo-rotatory isomer (1-so talol) rather than any substantial cardiodepressant effect of the dext ro-rotatory isomer.