Positive inotropic and vasodilator effects of MDL 17,043 in patients with reduced left ventricular performance

• Published in: The American journal of cardiology Vol. 53; no. 8; pp. 1051 - 1053
• Main Authors: Crawford, Michael H., Richards, Kent L., Sodums, Marcis T., Kennedy, Gemma T.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1984; Elsevier
• Subjects: Adult; Biological and medical sciences; Cardiotonic agents; Cardiotonic Agents - pharmacology; Cardiotonic Agents - therapeutic use; Cardiovascular system; Enoximone; Heart Failure - drug therapy; Heart Ventricles - physiopathology; Hemodynamics - drug effects; Humans; Imidazoles - pharmacology; Imidazoles - therapeutic use; Male; Medical sciences; Middle Aged; Myocardial Contraction - drug effects; Pharmacology. Drug treatments; Stimulation, Chemical; Vasodilation - drug effects; Human; Cardiotonic agent; Chemotherapy; Treatment; Vasodilator agent; Cardiovascular disease; Left ventricular failure
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(84)90635-0

To assess the potential positive inotropic properties of the drug MDL 17,043, 10 patients were studied who had impaired left ventricular (LV) performance and who were undergoing diagnostic cardiac catheterization (LV ejection fraction 16 to 46%). MDL 17,043 was given in repeated i.v. doses of 0.5 mg/kg every 15 minutes until a maximal effect was observed or a total dose of 3 mg/kg was attained. Cardiac output increased from 3.5 ± 1.0 to 5.3 ± 0.7 liters/min (p <0.005); pulmonary artery wedge pressure decreased from 22 ± 4 to 9 ± 5 mm Hg (p <0.001); and total systemic resistance decreased from 2,335 ± 1,147 to 1,310 ± 365 dyne cm −5 (p <0.025). Also, maximal LV dP/dt increased from 1,011 ± 301 to 1,243 ± 330 mm Hg/s (p <0.001). No significant changes in heart rate, systemic blood pressure, routine blood chemistries, complete blood counts or platelet counts were observed. Thus, MDL 17,043 has hemodynamic effects consistent with positive inotropic and vasodilating properties in patients with reduced LV performance. Because this agent is effective orally, further evaluation in patients with overt congestive heart failure is warranted.