Influence of long-term treatment with ketanserin on blood pressure, pulmonary artery pressure, and cardiac output in patients with heart failure.

Ketanserin is a selective serotonin2-receptor blocker and by this mechanism decreases peripheral resistance and blood pressure in hypertensives. We examined the hemodynamic effects of ketanserin during long-term treatment in patients with heart failure. Five male patients with coronary artery disease and heart failure (NYHA classes II-III) were treated with ketanserin (80 mg daily) for 12 months. Before treatment, after 4 weeks, and after 12 months treatment, a Swan-Ganz catheter was placed into the pulmonary artery and pulmonary wedge pressure, cardiac output, mean arterial pressure, and heart rate were measured at rest and on exertion. The pulmonary wedge pressure at rest decreased from 8 mmHg before to 6 mmHg after 4 weeks and 12 months treatment; on exertion, it decreased from 31 mmHg before treatment to 24 mmHg after 4 weeks treatment and to 21 mmHg after 12 months treatment. The mean arterial pressure also decreased at rest and on exertion after 4 weeks treatment as well as after 12 months treatment. Cardiac output increased slightly and heart rate was unaltered. No serious side effects occurred. Ketanserin could become an alternative vasodilator drug in the treatment of patients with heart failure.