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Indoramin in heart failure: Possible adverse effects on hemodynamics and exercise capacity
Author(s) -
Seth Love,
Galiè Nazzareno,
Casebolt Penny,
Gimenez Horacio,
Malloy Mark,
Franciosa Joseph A
Publication year - 1986
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1986.225
Subject(s) - hemodynamics , medicine , vascular resistance , heart failure , heart rate , cardiac output , cardiac index , pulmonary wedge pressure , blood pressure , vasodilation , anesthesia , cardiology
Indoramin is an α 1 ‐adrenergic antagonist vasodilator of potential value in heart failure. We measured hemodynamics and exercise capacity in 12 patients with heart failure, before and after 1 week of indoramin dosing, 75 mg b.i.d. Maximal hemodynamic effects 2 hours after the first dose of indoramin consisted of reduced mean systemic arterial pressure from 96.0 ± 15.3 to 87.9 ± 15.3 mm Hg (P < 0.05) and pulmonary wedge pressure from 23.6 ± 7.8 to 16.9 ± 6.6 mm Hg (P < 0.001). Heart rate, cardiac index, and total systemic resistance did not change acutely after indoramin, but after 1 week mean systemic arterial pressure was still reduced whereas cardiac index fell from 2.69 ± 0.38 to 2.32 ± 0.44 L/min/m 2 (P < 0.05) and total systemic resistance rose from 20.4 ± 2.8 to 21.9 ± 4.0 U (P < 0.1). After 1 week maximal exercise oxygen uptake fell from 16.8 ± 5.6 to 12.5 ± 3.5 ml/min/kg (P < 0.02). This limited observation suggests that indoramin is a predominant venodilator acutely in patients with heart failure but that despite this effect it may worsen functional capacity and hemodyanmics during continuous dosing in these patients. Clinical Pharmacology and Therapeutics (1986) 40, 567–574; doi: 10.1038/clpt.1986.225