Beta blockade increases pulmonary and systemic transit time heterogeneity: evaluation based on indocyanine green kinetics in healthy volunteers

Clin Physiol Funct Imaging. 2017 May;37(3):270-275. doi: 10.1111/cpf.12295. Epub 2015 Aug 24.

Abstract

Knowledge of factors influencing the heterogeneity of blood transit times is important in cardiovascular physiology. The aim of the study was to investigate the effect of beta-adrenergic blockade on blood transit time dispersion in awake, anxious volunteers. Recirculatory modelling of the disposition of intravascular markers using parametric forms for transit time distributions, such as the inverse Gaussian distribution, provides the opportunity to estimate the systemic and pulmonary transit time dispersion in vivo. The latter is determined by the flow heterogeneity in the microcirculatory network. Using this approach, we have analysed indocyanine green (ICG) disposition data obtained in four subjects by frequent early arterial blood sampling before and after beta-adrenergic blockade by propranolol. Propranolol decreased cardiac output from 9·3 ± 2·8 l min-1 to 3·5 ± 0·47 l min-1 (P<0·05). This reduction was accompanied by a 4·5 ± 0·6-fold and 2·1 ± 0·3-fold increase (P<0·001) in the relative dispersion (dimensionless variance) of blood transit times through the systemic and pulmonary circulation, respectively.

Keywords: cardiac output; flow heterogeneity; propranolol; recirculatory model; transit time distribution.

MeSH terms

  • Adrenergic beta-Antagonists / pharmacology*
  • Blood Flow Velocity / drug effects
  • Cardiac Output / drug effects
  • Chromatography, High Pressure Liquid
  • Computer Simulation
  • Fluorescent Dyes / administration & dosage
  • Fluorescent Dyes / pharmacokinetics*
  • Healthy Volunteers
  • Humans
  • Indocyanine Green / administration & dosage
  • Indocyanine Green / pharmacokinetics*
  • Male
  • Microcirculation / drug effects
  • Models, Cardiovascular
  • Propranolol / pharmacology*
  • Pulmonary Circulation / drug effects*

Substances

  • Adrenergic beta-Antagonists
  • Fluorescent Dyes
  • Propranolol
  • Indocyanine Green