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European Heart Journal 1984 5(2):158-167;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

Cardiovascular effects of sulmazol administered intravenously to patients with severe heart failure

F. HAGEMEIJER, A. SEGERS and A. SCHELLING

Department of Cardiology Sint Franciscus Gasthuis, Rotterdam, The Netherlands

Received 26 May 1983; revised 21 July 1983; .

Address for correspondence: Dr F. Hagemeijer, Sint Franciscus Gasthuis, Kleiweg 500, 3045 PM. Rotterdam, The Netherlands.

Abstract

Ten patients with severe heart failure (NYHA class IV) received sulmazol intravenously under haemody-namic and electrocardiographic surveillance. All patients were on maintenance doses of digitalis and diuretics. At 30 min intervals we increased the infusion rale of sulmazol from 1 to 2, 4, 6, and 8 mg min–1, to a total of 630 mg of sulmazol administered over 150 min.

Statistically significant changes (P<0-001) were found for heart rate (from 97 to 103 min–1); right atrial pressure (from 9-5 to 1-5 mmHg); pulmonary artery diastolic pressure (from 25-0 to 9-0 mmHg); pulmonary capillary wedge pressure (from 22-0 to 9-0 mmHg); aortic diastolic pressure (from 62-5 to 52-5 mmHg); pulmonary artery oxygen saturation (from 53-0 to 68-5%); cardiac output (from 2-83 to 4-381 min–1), and for indices derived from these measurements. No correlation was found between the improvement in cardiac performance and sulmazol plasma concentrations. Haemodynamic improvement persisted for more than 7-5 h after cessation of sulmazol administration. Renal function was measured before and after sulmazol administration; creatinine clearance (from 47-5 to 52-0 ml min–1) and p-amino hippuric acid clearance (from 146 to 125 ml min–1) were unchanged. Side-effects included yellow-colored vision, ventricular extrasystoles, and possibly sulmazol-induced liver function disturbances.

Even in severe heart failure sulmazol improved cardiac performance in patients who were treated with the maximum tolerated dose ofdigoxin.

Key Words: Heart failure • haemodynamics • inotrapic agent • sulmazol • toxicity • vasolilators


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