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• W1973163757 abstract "MDL-17,043, a new inotropic drug with vasodilator properties, has been shown to produce salutary hemodynamic effects in severe heart failure, but its effects on myocardial metabolism are unknown. To determine whether such hemodynamic effects are associated with adverse effects on the myocardial oxygen demand and supply relationship, we evaluated the effects of intravenous MDL-17,043 given in incremental doses to a mean maximum dose of 2.1 mg/kg, in nine patients with severe chronic heart failure. Overall cardiac pump performance was significantly improved by MDL-17,043, as reflected by an 88% increase in stroke work index (17 ± 11 to 32 ± 19 gm-m/m2; p < 0.001), a 43% reduction in left ventricular filling pressure (28 ± 4 to 16 ± 5 mm Hg; p < 0.0001), a 49% reduction in systemic vascular resistance (1832 ± 490 to 937 ± 296 dynes-sec-cm−5; p < 0.0001) with a slight (11%) decrease in mean arterial pressure (86 ± 17 to 76 ± 19 mm Hg; p = 0.005) and without significant changes in heart rate (88 ± 14 to 91 ± 12 bpm; p = NS). These hemodynamic effects were associated with an 18% reduction in myocardial oxygen consumption (17 ± 5 to 14 ± 5 ml/min p = 0.01), a 17% reduction in myocardial arteriovenous oxygen difference (13.2 ± 2.4 to 10.9 ± 1.8 volumes %; p = 0.01), and a 120% improvement in external myocardial efficiency (stroke work index/oxygen consumption) (1.0 ± 0.6 to 2.2 ± 0.9; p < 0.0001). There were no overall changes in coronary sinus blood flow (126 ± 31 to 124 ± 38 ml/min; p = NS) or percentage of myocardial lactate extraction (38 ± 12 to 28 ± 19; p = NS). The decline in myocardial oxygen consumption suggests that concomitant reduction in preload and afterload may have more than offset the increase in myocardial oxygen consumption expected secondary to the known inotropic effect of the drug. We conclude that short-term intravenous MDL-17,043 produces salutary acute hemodynamic effects in severe heart failure and that these effects are associated with an improved external myocardial efficiency without adverse effects on global myocardial energetics." @default.
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• W1973163757 date "1984-11-01" @default.
• W1973163757 modified "2023-09-29" @default.
• W1973163757 title "Myocardial metabolic and hemodynamic effects of intravenous MDL-17,043, a new cardiotonic drug, in patients with chronic severe heart failure" @default.
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• W1973163757 doi "https://doi.org/10.1016/0002-8703(84)90755-5" @default.
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