Direct positive inotropic effect of mannitol on the intact canine heart.

Infusion of 25% mannitol into either the circumflex or left anterior descending coronary artery caused a significant increase in myocardial force development, measured by means of strain gauge in 10 anesthetized dogs. The changes were confined to the area perfused. The increase in developed force was dose-dependent, 20% at an infusion rate of 0.55 ml/min, 28% at 1.4 ml/min, 32% at 2.8 ml/min and 57% at 5.5 ml/min. There was a similar increase in dF/dt. The increase in developed force in the first minute was also dose-dependent, being 9% at 0.55 ml/min and 40% at 5.5 ml/min. No change in developed force occurred in the control (non-perfused) area or during saline infusion of the same artery at similar rates. A decrease in developed force of 10.5% was observed after the initial rise when mannitol was infused at 5.5 ml/min. This effect did not completely abolish the initial increase. No change in blood pressure, heart rate, LV systolic and diastolic pressure of LV dp/dt occurred during the experiment. It is concluded that doses of mannitol which are in clinical use have a direct positive inotropic effect on the intact canine heart.