Herz
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Beta-adrenergic blocking agents exert a number of pharmacologic effects which may potentially be beneficial and warrant their use in acute myocardial infarction: by decreasing heart rate, myocardial contractility and systolic blood pressure, reducing catecholamine-induced lipolysis and antagonizing the oxygen-wasting effects of catecholamines on the myocardium, myocardial oxygen balance may be improved thus reducing ischemia. Theoretically this may lead to a limitation of infarct size by protecting underperfused myocardium from ultimate necrosis. Definite proof for such a positive effect in man, however, is not yet available. ⋯ In conclusion, beta-adrenoceptor blocking agents appear to represent a promising therapeutic principle for protecting ischemic myocardium in acute infarction. Additional investigations are urgently necessary to clarify the question of which patients may profit from such management. Pending the results of such studies, a general recommendation for the treatment of myocardial infarction with beta-blockade can not yet be given.