Effects of CI-914 in congestive heart failure due to coronary artery disease or idiopathic cardiomyopathy

Abstract

The hemodynamic effects of CI-914, a phosphodiesterase inhibitor, were studied in 12 patients with left ventricular (LV) dysfunction who were undergoing diagnostic cardiac catheterization. CI-914 was infused intravenously at a rate of 0.8 to 7.0 [mu]g/kg/min for 30 to 60 minutes; hemodynamic values were measured every 10 minutes. No effect was seen in the patient receiving 0.8 [mu]g/kg/min. At infusion rates of 1.2 to 2.4 [mu]g/kg/min, cardiac index increased by 14% (p 2, cardiac index increased by 50% (p 2 (group A). Although systemic vascular resistance decreased in all 8 patients by 26% (p 2; the double product fell from 101 +/- 31 to 91 +/- 23 (NS). In all 12 patients, a linear correlation between peak venous blood concentration and peak effect on cardiac index, systemic vascular resistance and pulmonary artery wedge pressure was observed. The increase in cardiac index associated with a decrease in systemic vascular resistance suggests that part of the favorable hemodynamic effect is attributable to afterload reduction. Nonetheless, the increase in peak +dP/dt in all patients suggests that CI-914 also has a positive inotropic effect. This combination of effects may be of value in the treatment of severe congestive heart failure.