The effect of propranolol on microvascular injury in acute myocardial ischemia.

The purpose of this study was to determine whether propranolol, which has been shown to reduce the extent of myocardial infarction, reduces microvascular injury which may play a role in exacerbating ischemia. Saline (10 dogs) or propranolol (2 mg/kg i.v., 7 dogs) was injected prior to a one hour occlusion of the left anterior descending coronary artery. Carbon black (1 ml/kg), which labels damaged and leaky vessels, was injected 5 min after release of the occlusion and allowed to circulate for two hours. By morphometric analysis of 1 micron thick sections, 75 +/- 12% of vessels and 84 +/- 7% of myocardial cells showed damage in untreated dogs; only 2 +/- 1% of vessels and 9 +/- 8% of myocardial cells showed damage in the propranolol-treated dogs (P less than 0.001). The number of carbon black-labeled vessels/10 fields/biopsy from comparable areas of ischemic tissue was 55 +/- 7 in untreated dogs and 27 +/- 3 in propranolol-treated dogs (P less than 0.001). The results suggest that propranolol not only protects the ischemic myocardial cell, but also significantly decreases the ischemic microvascular changes.