Influence of UDCG-115 on hemodynamics and myocardial energetics in patients with idiopathic dilated cardiomyopathy.

The influence of the new inotropic and vasodilating agent UDCG-115 on hemodynamics and myocardial oxygen metabolism was investigated in 11 patients with idiopathic dilated cardiomyopathy (New York Heart Association class II to III). After intravenous administration of UDCG-115, cardiac index increased from 3.03 +/- 0.68 to 3.76 +/- 1.07 L/min/m2 (p less than 0.01), left ventricular ejection fraction increased from 31 +/- 13 to 39 +/- 16% (p less than 0.01), and maximum rate of left ventricular pressure rise increased from 935 +/- 248 to 1056 +/- 284 mm Hg/sec (p less than 0.05). Left ventricular end-diastolic wall stress (index of preload) and left ventricular end-systolic wall stress (index of afterload) decreased by 41% (p less than 0.01) and 34% (p less than 0.001), respectively. Heart rate did not change significantly. With UDCG-115 myocardial oxygen consumption decreased from 14.3 +/- 5.1 to 10.6 +/- 3.8 ml/min/100 gm (p less than 0.05), and the ratio of myocardial oxygen supply to myocardial oxygen demand increased from 1.40 +/- 0.08 to 1.53 +/- 0.17 (p less than 0.05). Thus intravenous UDCG-115 improves left ventricular function by increasing inotropism and reducing preload and afterload in patients with idiopathic dilated cardiomyopathy and moderate congestive heart failure. The systemic hemodynamic actions are associated with favorable effects on myocardial energetics.