What question did this study set out to answer?

To evaluate the pharmacokinetics and hemodynamic consequences of the cardiotonic agent MDL 17,043 in patients with congestive heart failure compared with sodium nitroprusside.

November 1, 1983Journal of Cardiovascular Pharmacology

Hemodynamic Effects of MDL 17,043, a New Cardiotonic Agent, in Patients with Congestive Heart Failure

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Why the study?

Does MDL 17,043 improve hemodynamic parameters compared to sodium nitroprusside in patients with congestive heart failure?

Population

14 patients with congestive heart failure (stages II-III)

Comparison

MDL 17,043 given intravenously at a single dose… vs Sodium nitroprusside given at a dose lowering…

Design

Cohort

Follow-up

Acute (minutes to hours)

Authors

RARobert ArbogastInstitut Pasteur CBChristian BrandtBethel University KHKlaus D. HaegeleKlinikum St. Georg

Discussion

Member takes

Implication

Supports inotropic effects of MDL 17,043 in HF beyond vasodilation; hypothesis-generating and should not yet change practice.

Key Points

To evaluate the pharmacokinetics and hemodynamic consequences of the cardiotonic agent MDL 17,043 in patients with congestive heart failure compared with sodium nitroprusside.
Administered an intravenous dose of 0.5 mg/kg MDL 17,043 to 14 patients with stage II-III congestive heart failure.
Compared hemodynamic responses between MDL 17,043 and sodium nitroprusside in 8 patients, measuring elimination half-lives and contractility markers.
MDL 17,043 increased cardiac output (p < 0.001) while significantly lowering total peripheral resistance (p < 0.001) and left ventricular end-diastolic wedge pressure (p < 0.001).
Unlike sodium nitroprusside, MDL 17,043 increased left ventricular stroke work without increasing myocardial oxygen uptake (tension-time index, p > 0.2).

Structured PICO

Does MDL 17,043 improve hemodynamic parameters compared to sodium nitroprusside in patients with congestive heart failure?

Population

14 patients with congestive heart failure (stages II-III)

Intervention

MDL 17,043 given intravenously at a single dose of 0.5 mg/kg

Comparator

Sodium nitroprusside (SN) given at a dose lowering mean blood pressure by 20 mm Hg (in a subset of 8 patients)

Outcome

Hemodynamic effects including cardiac output, total peripheral resistance, left ventricular end-diastolic pressure, and left ventricular stroke worksurrogate

MDL 17,043 acts as both a peripheral vasodilator and a direct positive inotrope, improving myocardial contractile state without increasing myocardial oxygen uptake in patients with congestive heart failure.

Cite This Study

Arbogast et al. (1983) studied this question.

synapsesocial.com/papers/6a7788ff6789de8d0af74665 https://doi.org/10.1097/00005344-198311000-00013

Topics

Heart failure HFrEF treatment

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Hemodynamic Effects of MDL 17,043, a New Cardiotonic Agent, in Patients with Congestive Heart Failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Hemodynamic Effects of MDL 17,043, a New Cardiotonic Agent, in Patients with Congestive Heart Failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider