Author + information
- Received February 9, 1987
- Revision received May 28, 1987
- Accepted June 6, 1987
- Published online November 1, 1987.
- Alex Sagie, MD1,
- Samuel Sclarovsky, MD*,1,
- Eliezer Klainman, MD1,
- Boris Strasberg, MD, FACC1,
- Eldad Rechavia, MD1,
- Aviv Mager, MD1,
- Jairo Kusniec, MD1 and
- Jacob Agmon, MD, FACC1
- ↵*Address for reprints: Samuel Sclarovsky, MD, Massada Center for Heart Diseases, Beilinson Medical Center, Petah Tikva 49100, Israel.
This study was designed to evaluate the effects of metaraminol (Aramine) in six patients with evolving acute inferior wall myocardial infarction accompanied by hypotension and warm limbs. There were 16 episodes of acute inferior wall ischemia, and the response to therapy was judged by evaluating blood pressure and ST segment and T wave abnormalities. Three patients received intravenous isosorbide dinitrate and two received streptokinase as the initial therapy. The mean ST segment elevation was significantly reduced (from 4.94 ± 1 to 0.5 ± 0.7 [p < 0.0001]) after metaraminol infusion was initiated. The average T wave height also decreased (from 6.8 ± 2 to −1.3 ± 2.5 mm [p < 0.0005]). The average heart rate decreased from 82 ± 11 to 69 ± 9 beats/min (p < 0.05) and the mean arterial blood pressure increased from 81 ± 12 mm Hg before metaraminol treatment to 126 ± 8 mm Hg after treatment. All these changes occurred within a few minutes after metaraminol therapy was instituted. In 12 episodes, accelerated idioventricular rhythm appeared concomitantly with the resolution of ST segment elevation.
Coronary angiography performed between 4 and 10 days after admission demonstrated significant obstruction in all infarct-related arteries, but none was totally occluded. Left ventricular function was normal in three patients and slightly hypokinetic in the inferior wall in two.
These results indicate that in a selected group of patients with acute inferior myocardial infarction, metaraminol administration (in certain hemodynamic circumstances) can alleviate acute ischemia within a few minutes and thereby reduce ischemic injury.
- Received February 9, 1987.
- Revision received May 28, 1987.
- Accepted June 6, 1987.
- American College of Cardiology Foundation