Effects of Propranolol on Regional Myocardial Function, Electrograms, and Blood

was assessed by measurements of segment length (SL), velocity of SL shortening and regional myocardial "work", i.e., pressure-length loops in normal, moderately, and severely ischemic zones. Regional intramyocardial electrograms were measured from the same sites along with regional myocardial blood flow as determined by the radioactive microsphere technique. Coronary occlusion resulted in graded loss of function from the normal to severely ischemic zones with graded flow reduction and graded elevation of the ST segment. Propranolol depressed overall LV function, function in the normal zone (work fell by 17+4%), and in the majority of moderately ischemic segments (work fell by 7±+-3%). In severely ischemic segments the extent of paradoxical motion and post-systolic shortening was reduced by propranolol. After propranolol regional myocardial blood flow fell in the normal zone (11+2%) and rose in the moderately (15+4%) and severely (63+10%) ischemic zones. Thus, in the conscious dog with regional myocardial ischemia, propranolol induces a redistribution of myocardial blood flow, with flow falling in normal zones and rising in moderately and severely ischemic zones. The improvement in perfusion of ischemic tissue was associated with slight but significant depression of shortening, velocity, and work in the moderately ischemic Dr. Vatner is an Established Investigator of the American Heart Association. Dr. Pagani is a Postdoctoral Research Fellow, 1 F05 TW02331-01, of the U. S. Public Health Service. Received for publication 31 December 1976 and in revised form 14 March 1977. zones and of paradoxical bulging and post-systolic shortening in the severely ischemic zone.