Methylprednisolone treatment in acute myocardial infarction: Effect on regional and global myocardial function

J Osher, TW Lang, S Meerbaum, K Hashimoto… - The American Journal of …, 1976 - Elsevier
J Osher, TW Lang, S Meerbaum, K Hashimoto, JC Farcot, E Corday
The American Journal of Cardiology, 1976Elsevier
The effects of methylprednisolone treatment on acute myocardial ischemia were studied in
nine closed chest dogs. After 1 hour of proximal occlusion of the left anterior descending
coronary artery, an intravenous bolus injection (50 mg/kg body weight) of
methylprednisolone was administered and its effects studied during an additional 2 hours of
occlusion. After 2 hours of treatment the following significant mean alterations from levels
after 1 hour of occlusion were noted: an increase of 16.7 percent in heart rate and decreases …
Abstract
The effects of methylprednisolone treatment on acute myocardial ischemia were studied in nine closed chest dogs. After 1 hour of proximal occlusion of the left anterior descending coronary artery, an intravenous bolus injection (50 mg/kg body weight) of methylprednisolone was administered and its effects studied during an additional 2 hours of occlusion. After 2 hours of treatment the following significant mean alterations from levels after 1 hour of occlusion were noted: an increase of 16.7 percent in heart rate and decreases of 23 percent in left ventricular end-diastolic pressure, 32 percent in stroke volume, 14 percent in cardiac output and 37 percent in stroke work. Peak systolic pressure, maximal rate of rise of left ventricular pressure (dP/dt), left ventricular end-diastolic volume, systemic vascular resistance and coronary sinus blood flow changed less than 10 percent. Ejection fraction and regional cardiac wall motion were not improved. Metabolic dysfunction of the coronary-occluded myocardium, revealed by regional lactate as well as potassium derangements, persisted throughout the 2 hour treatment period.
Comparison of these results with equivalent data from an untreated series of nine dogs with 3 hours of occlusion demonstrated no improvement in the treated series. Methylprednisolone failed to restore regional cardiac metabolic and mechanical function, and treatment was associated with a further rise in S-T segment elevations. Administration of methylprednisolone after 1 hour of proximal left anterior descending coronary occlusion apparently does not reverse cardiac dysfunction in the first 2 hours of treatment.
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