Abstract
Perioperative β-blockade reduces the incidence of myocardial infarction, but is associated with an increased incidence of ischemic stroke, particularly in the context of acute surgical blood loss and fluid resuscitation (hemodilution). Metoprolol, a relatively poor β1-selective antagonist, impaired cerebral perfusion in an experimental model of acute hemodilution. The mechanism may include attenuation of the cardiac output (β1-effect) and cerebral vasodilatory response to hemodilution (β2-effect).
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