Journal of cardiovascular pharmacology and therapeutics
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J. Cardiovasc. Pharmacol. Ther. · Dec 2009
ReviewClinical Review: Is the perioperative use of beta-blockers still recommended? A critical review of recent controversies.
The optimal role of beta-adrenergic receptor blockade in the perioperative period remains unclear in patients at risk for cardiovascular events. Cardiovascular complications continue to be the most common cause of perioperative morbidity and mortality, and cardioprotective properties of beta-blockers are widely recognized, yet the results of the clinical trials investigating the use of different beta-blockers in the perioperative period are controversial. ⋯ Evidently, perioperative mortality and morbidity seem to be related to heart rate, and the majority of complications are related to beta-blockers' side effects. Based on the observations from different studies, we propose an algorithm for perioperative beta blockade.
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J. Cardiovasc. Pharmacol. Ther. · Dec 2009
Comparative StudyNeither K+ channels nor PI3K/Akt mediates the vasodilative effect of nebivolol on different types of rat arteries.
Nebivolol is a highly selective beta(1)-adrenoceptor blocker with additional vasodilating properties. It has been shown that the nebivolol-induced vasorelaxation is nitric oxide (NO) dependent. The serine/ threonine protein kinase Akt phosphorylates endothelial cell NO synthase (eNOS) and enhances the ability of eNOS to generate NO. Previous studies have shown that the release of NO from the endothelium may be ascribed to the modulation of different types of K(+) channels. The current study was designed to determine whether K(+) channels or phosphatidylinositol-3-kinase (PI3K)/Akt may affect vasorelaxation induced by nebivolol in different rat arteries. ⋯ Nebivolol produced a concentration-dependent vasodilation in different rat arteries precontracted by PE or KCl. In the isolated rat aorta, carotid artery, femoral artery, and renal artery, neither K(+) channels nor PI3K/Akt pathway was involved in the relaxation induced by nebivolol.