Problems in assessment of new pharmacologic agents for the heart failure patient.
Publication/Presentation Date
9-1-1981
Abstract
Modern management of congestive heart failure (CHF) employs inotropic drugs, vasodilators, and diuretics. Although pharmacologic classification of drugs is possible in animals, identification of predominant hemodynamic mechanisms in humans is more complex, because many effects of vasodilators and inotropic drugs are similar. We compared the effects of a vasodilator, prazosin, and two agents with both inotropic and vasodilatory properties, amrinone and pirbuterol, on cardiac index (CI), mean aortic pressure, left ventricular stroke work index (LVSWI), LV filling pressure (LVFP), systemic vascular resistance, LV ejection fraction (LVEF), and myocardial O2 consumption (MVO2) in 34 patients with advanced CHF. We concluded that (1) a rise in CI and LVEF, together with a fall in LVFP, does not necessarily indicate an inotropic effect; (2)both CI and LVEF may be increased by an inotropic mechanism in advanced CHF without a rise in MVO2; and (3) a drug-induced rise in LVSWI with stable or lower LVFP suggests an inotropic mechanism of action.
Volume
102
Issue
3 Pt 2
First Page
584
Last Page
590
ISSN
0002-8703
Published In/Presented At
Rude, R. E., Grossman, W., Colucci, W. S., Benotti, J. R., Carabello, B. A., Wynne, J., Malacoff, R., & Braunwald, E. (1981). Problems in assessment of new pharmacologic agents for the heart failure patient. American heart journal, 102(3 Pt 2), 584–590. https://doi.org/10.1016/0002-8703(81)90748-1
Disciplines
Medicine and Health Sciences
PubMedID
7270403
Department(s)
Department of Medicine
Document Type
Article