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Sclerosing peritonitis and propranolol.

S Ahmad
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Abstract

Sclerosing peritonitis developed in a 56-year-old white man who had been receiving propranolol (320 mg/day) for hypertension and angina pectoris since December 1976. The patient had abdominal pain, loss of weight, pleural effusion, and gastrointestinal hemorrhage. Laparotomy revealed extensive adhesions which were so remarkable that the organs were fixed. Infectious and neoplastic causes of fibrosing peritoneal inflammation were excluded. To my knowledge the development of sclerosing peritonitis with extensive colonic involvement and colonic hemorrhage has been been described previously with therapy with propranolol.

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Angina PectorisColonGastrointestinal HemorrhageHumansHypertensionMaleMiddle AgedPeritonitisPleural EffusionPropranololRadiographySubstance Withdrawal SyndromeCase ReportsJournal Article

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BibTeXRIS

S Ahmad. 1981. Sclerosing peritonitis and propranolol.. https://doi.org/10.1378/chest.79.3.361

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Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris.

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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