The acute hemodynamic effects of a new agent, MDL 17,043, in the treatment of congestive heart failure

Abstract

MDL 17,043 administered intravenously or orally exerts positive inotropic and vasodilator actions in experimental animal preparations. We studied its acute hemodynamic effects in 15 patients with severe congestive heart failure by right-heart catheterization. Intravenous MDL 17,043 at 10 minutes increased cardiac index (3.4 ± 0.8 vs 1.9 ± 0.4 l/min/m2), narrowed arteriovenous oxygen content difference (4.6 ± 0.8 vs 7.8 ± 2.0 vol%), increased heart rate (98 ± 14 vs 89 ± 18 beats/min), and decreased systemic arterial (67 ± 10 vs 83 ± 11 mm Hg), pulmonary capillary wedge (12 ± 5 vs 24 ± 5 mm Hg) and right atrial (6 ± 5 vs 12 ± 7 mm Hg) mean pressures significantly (p<0.001). In 11 patients, hemodynamics were monitored hourly for 6 hours. Compared with baseline, the cardiac index and heart rate were higher and mean systemic arterial pressure was lower for 6 hours; pulmonary capillary and right atrial mean pressures were significantly lower for 5 hours. No serious arrhythmias or side effects occurred. These data suggest that MDL 17,043 may be useful for treating congestive heart failure.