Hemodynamic effects of prostaglandin E1 infusion in patients with acute myocardial infarction and left ventricular failure

Abstract

Prostaglandin E1 (PGE1) has been shown to limit infarct size, improve coronary blood flow, inhibit platelet aggregation, and reduce both left ventricular (LV) preload and afterload in experimental animals. Its use in the therapy of patients with acute myocardial infarction (AMI) and congestive heart failure (CHF) has not, however, been reported. Five patients with AMI of less than 12 hours' duration and LV dysfunction were studied to assess the hemodynamic effects of IV infusion of PGE1. PGE1 in the concentration of 0.4 [mu]g/ml was infused at a rate of 0.003 [mu]g/kg/min (3 ng [middle dot] kg-1 [middle dot] min-1) to a maximum rate of 0.021 [mu]g/kg/min (21 ng [middle dot] kg-1 [middle dot] min-1) for a total time of up to 90 minutes. There was an insignificant increase in heart rate, with significant decreases in mean arterial blood pressure and systemic vascular resistance. Pulmonary capillary wedge pressure declined from 21 +/- 3 to 15 +/- 1 mm Hg (p p 2 (p p 1 infusion. One patient had transient nausea which did not require discontinuation of the drug. PGE1 is an effective vasodilator and deserves further application in therapy for AMI patients with CHF.