MECHANISM AND EFFECTS OF AR-L 115 BS IN CORONARY HEART-DISEASE - IMPROVED LEFT-VENTRICULAR FUNCTION AND LEFT-VENTRICULAR WALL MOTION WITHOUT ANGINA-PECTORIS

  • 1 January 1982
    • journal article
    • research article
    • Vol. 71  (11) , 736-746
Abstract
The use of new cardiotonic drugs, such as AR-L115BS (ARL), in patients with coronary artery disease(CAD) might be limited by their aggravating myocardial ischemia (MIS). ARL (2 mg/kg body wt i.v.) hemodynamics, myocardial O2 consumption (MVO2) and regional wall motion (RWM) were investigated in 30 patients with CAD presenting with pacing-induced MIS (angina, rise of LVEDP [left ventricular end-diastolic pressure], lactate production). ARL improved LV-pump function in 13 group-1 patients (average increases: cardiac index by +25%; LV-work by +17%; dp/dtmax by +30%; coronary sinus flow by +39%), while there was a decrease in preload (LVEDP by -44%) and afterload (AOMP by -9%), and cardiac efficiency by -25%. Such ARL-effects required a rise of MVO2 by +41% but did not induce MIS. These beneficial results were corroborated by significant hemodynamic improvements also in 17 group-2 patients when comparing the non-medicated immediate postpacing period (PPP) with MIS vs. the ARL-mediated PPP (= PPP + ARL) without MIS, where RWM improved by an overall average of 26 .+-. 11% in the phase PPP + ARL. In CAD ARL improves hemodynamics and RWM. The mechanism is pre- and afterload reduction, increase in contractility, MVO2 and CSF without MIS being induced.