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Hemodynamic effects of dibutyryl cyclic AMP in congestive heart failure
Insights
Dibutyryl cyclic AMP (DBcAMP) effectively reduces vascular resistance and improves cardiac output in patients with congestive heart failure (CHF). This study indicates DBcAMP is a potent vasodilator, suggesting its potential as a therapeutic agent for CHF treatment.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Congestive heart failure (CHF) is a complex syndrome characterized by impaired cardiac function.
- Vasodilator therapy is crucial in managing CHF, aiming to reduce cardiac workload and improve hemodynamics.
Purpose of the Study:
- To investigate the hemodynamic effects of dibutyryl cyclic AMP (DBcAMP) in patients diagnosed with congestive heart failure (CHF).
- To assess the potential of DBcAMP as a vasodilating agent for CHF treatment.
Main Methods:
- Right-sided cardiac catheterization was performed on 11 patients with CHF.
- Hemodynamic variables were measured before and after intravenous infusion of DBcAMP at varying doses (0.025 to 0.2 mg/kg/min).
Main Results:
- DBcAMP significantly reduced systemic vascular resistance index and pulmonary arterial end-diastolic pressure.
- Cardiac index increased substantially, accompanied by a decrease in systemic vascular resistance.
- Most patients tolerated DBcAMP, demonstrating dose-related hemodynamic improvements.
Conclusions:
- DBcAMP exhibits potent vasodilating effects on resistance vessels in CHF patients.
- DBcAMP demonstrates potential as a beneficial therapeutic agent for treating congestive heart failure.
Abstract:
To evaluate the hemodynamic effects of dibutyryl cyclic AMP (DBcAMP) in congestive heart failure (CHF), right-sided cardiac catheterization was performed in 11 patients with CHF, and hemodynamic variables were investigated before and after infusion of various doses of DBcAMP at a rate of 0.025 to 0.2 mg/kg/min (mean 0.14 +/- 0.077 [standard deviation]). DBcAMP reduced total systemic vascular resistance index from 3,171 +/- 1,158 to 1,880 +/- 554 dynes s cm-5 X m2 (mean +/- standard deviation) and pulmonary arterial end-diastolic pressure from 23 +/- 13 to 20 +/- 11 mm Hg, and increased cardiac index from 2.24 +/- 0.60 to 3.41 +/- 1.02 liters/min/m2. Mean arterial blood pressure decreased from 91 +/- 14 to 84 +/- 13 mm Hg, and heart rate increased from 91 +/- 16 to 99 +/- 13 beats/min. The increase in cardiac index was accompanied by a proportional decrease in total systemic vascular resistance index in all patients except 1. In 8 patients the decrease in pulmonary arterial end-diastolic pressure was accompanied by an increase or no change in the left ventricular stroke work index. In 6 patients, DBcAMP was given in incremental doses of 0.05, 0.1, and 0.2 mg/kg/min every 20 minutes, and 5 of 6 patients tolerated the full dose and showed dose-related hemodynamic changes for the incremental doses of DBcAMP. These data suggest that DBcAMP has powerful vasodilating effects on resistance vessels in patients with CHF; hence, it can be a useful vasodilating agent for treatment of CHF.