Premium
Haemodynamic effects of the nitroxyl donor cimlanod ( BMS ‐986231) in chronic heart failure: a randomized trial
Author(s) -
Lang Ninian N.,
Ahmad Faheem A.,
Cleland John G.,
O'Connor Christopher M.,
Teerlink John R.,
Voors Adriaan A.,
Taubel Jorg,
Hodes Anke R.,
Anwar Mohamed,
Karra Ravi,
Sakata Yasushi,
Ishihara Shiro,
Senior Roxy,
Khemka Abhishek,
Prasad Narayana G.,
DeSouza Mary M.,
Seiffert Dietmar,
Ye June Y.,
Kessler Paul D.,
Borentain Maria,
Solomon Scott D.,
Felker G. Michael,
McMurray John J.V.
Publication year - 2021
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.2138
Subject(s) - medicine , lusitropy , placebo , heart failure , stroke volume , crossover study , inotrope , ejection fraction , cardiac index , preload , cardiology , anesthesia , cardiac output , hemodynamics , randomized controlled trial , cardiac function curve , blood pressure , diastole , alternative medicine , pathology
Aims Nitroxyl provokes vasodilatation and inotropic and lusitropic effects in animals via post‐translational modification of thiols. We aimed to compare effects of the nitroxyl donor cimlanod (BMS‐986231) with those of nitroglycerin (NTG) or placebo on cardiac function in patients with chronic heart failure with reduced ejection fraction (HFrEF). Methods and results In a randomized, multicentre, double‐blind, crossover trial, 45 patients with stable HFrEF were given a 5 h intravenous infusion of cimlanod, NTG, or placebo on separate days. Echocardiograms were done at the start and end of each infusion period and read in a core laboratory. The primary endpoint was stroke volume index derived from the left ventricular outflow tract at the end of each infusion period. Stroke volume index with placebo was 30 ± 7 mL/m 2 and was lower with cimlanod (29 ± 9 mL/m 2 ; P = 0.03) and NTG (28 ± 8 mL/m 2 ; P = 0.02). Transmitral E‐wave Doppler velocity on cimlanod or NTG was lower than on placebo and, consequently, E/e′ ( P = 0.006) and E/A ratio ( P = 0.003) were also lower. NTG had similar effects to cimlanod on these measurements. Blood pressure reduction was similar with cimlanod and NTG and greater than with placebo. Conclusion In patients with chronic HFrEF, the haemodynamic effects of cimlanod and NTG are similar. The effects of cimlanod may be explained by venodilatation and preload reduction without additional inotropic or lusitropic effects. Ongoing trials of cimlanod will further define its potential role in the treatment of heart failure.