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Comparative effects of tolamolol and propranolol on cardiac and peripheral circulatory function in patients with coronary artery disease

In a clinical study comparing the cardiocirculatory effects of intravenous tolamolol to those of propranolol, tolamolol, 16 mg, induced similar reduction in resting heart rate as 8 mg propranolol in 16 coronary patients. Tolamolol did not disturb cardiac pump performance and exerted less negative inotropic action than propranolol as assessed by mechanical contractility indices. Myocardial beta‐one chronotropic and inotropic stimulation by exogenous epinephrine was blocked equally by tolamolol and propranolol. Tolamolol exerted less systemic vascular beta‐two blockade than propranolol as assessed by the peripheral resistance and vasopressor responses to epinephrine irifusion. Tolamolol is a potent cardioselective beta antagonist with relatively less inotropic depressant action than propranolol and is thereby suitable for careful extension of beta blockade therapy to certain patients with pulmonary and ventricular dysfunction.