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European Heart Journal 1983 4(4):252-258;
Copyright © 1983 by the European Society of Cardiology.
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© 1983 The European Society of Cardiology

Prenalterol in primary dilated cardiomyopathy: hemodynamic and angiographic evaluation

A. BRANZI, S. SPECCHIA, G. BINETTI, C. MAGELLI, R. ZANNOLI and B. MAGNANI

Istituto di Malattie dell'Apparato Cardiovascolare dell'Università degli Studi di Bologna Italy

Received 13 November 1981; revised 23 February 1982; .

Requests for reprints to: Dr Angelo Branzi, Istituto di Malattie dell‘ Apparato Cardiovascolare dell' Università, Via Massarenti, 9–40138 Bologna, Italy.

Abstract

The hemodynamic effects of an acute infusion of prenalterol (PN), a new inotropic beta-adrenoceptor agonist, have been evaluated by cardiac catheterization in 10 patients with primary dilated (congestive) cardiomyopathy. A single dose of20µg/kg was administered over 5 min after basal hemodynamic and angiographic measurements. The administration of prenalterol caused a significant increase in mean cardiac index, from 2.3 to 3.3 l/min/m2 (P < 0.01) and mean stroke volume, from 47 to 62 ml (P < 0.01) without a change in heart rate. Mean left ventricular end-diastolic pressure was reduced from 19 to 13 mm Hg (P < 0.05) and left ventricular dp/dt rose from 902 to 1089 mm Hg/s (P < 0.01). Stroke work index increased from 27 to 40 gm/m2 (P < 0.01) and ejection fraction from 31 to 36% (P < 0.05). Mean blood pressure did not change and the systemic vascular resistance decreased from 24 to 17 RU (P < 0.01). The favorable effect of prenalterol on left ventricular relaxation was shown by an increase of peak negative left ventricular dp/dt from 946 to 1159 mm Hg/s and by a decrease of the time constant of left ventricular pressure fall from 49 to 39 s.

These results demonstrated a positive inotropic effect of prenalterol on patients with diffuse and severely reduced contractility.

Key Words: Prenalterol • primary dilated cardiomyopathy • heart failure therapy


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