The Effects of Carperitide(SUN 4936: .ALPHA.-Human Atrial Natriuretic Polypeptide) on Exercise- Induced Impairment of Left Ventricular Function in Patients with Chronic Heart Failure.

Effects of carperitide on cardiac function during dynamic exercise were studied in 11 patients, aged 50 to 68 years, with chronic heart failure.Changes in hemodynamic parameters during symptom-limited supine multistage bicycle ergometer exercise testing, in which initial work load of 25 w was increased stepwise by 25 w every 3 min, were compared before and after intra-pulmonary artery infusion of carperitide (0.05 or 0.1μg/kg/min, for 30 min).Following carperitide infusion at rest, systolic and diastolic blood pressure, systemic vascular resistance and pulmonary artery wedge pressure decreased significantly, while the heart rate increased signficantly.At the time of peak exercise, the pulmonary artery wedge pressure remained at a lower level (13.5±2.9mmHg ; mean±SEM) after the infusion of carperitide as compared to the case of placebo infusion (25.1±2.4mmHg, p<0.001). Other hemodynamic parameters including blood pressure, heart rate, cardiac index, coronary sinus flow, systemic vascular resistance, coronary vascular resistance, and myocardial oxygen consumption showed no significant diffe- rences between the carperitide and placebo groups.One of 2 patients receiving 0.1μg/kg/min of carperitide was withdrawn from the study due to the occurrence of abrupt hypotension. None of 9 patients receiving 0.05μg/kg/min experienced any adverse effect.These results suggest that infusion of carperitide at a moderate dose can exert some beneficial hemodynamic effects on exercise-induced impairment of left ventricular function in patients with chronic heart failure.