Long-term therapy with a new cardiotonic agent, WIN 47203: Drug-dependent improvement in cardiac performance and progression of the underlying disease

L. S. Sinoway, C. S. Maskin, B. Chadwick, Robert Forman, E. H. Sonnenblick, T. H. Le Jemtel

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Abstract

Seven patients with severe chronic congestive heart failure were treated with a new cardiotonic agent, WIN 47203 (an analog of amrinone), for an average of 7.4 weeks (range 2 to 15). At the initiation of therapy, hemodynamic improvement occurred in all patients as the cardiac index increased from 1.79 ± 0.39 to 2.30 ± 0.44 liters/min per m2 (probability [p] < 0.05) and pulmonary capillary wedge pressure decreased from 24.1 ± 6.7 to 16.1 ± 7.8 mm Hg (p < 0.05). Long-term therapy produced a substantial symptomatic improvement in five of the seven patients. This improvement was fully sustained in two patients and the remaining three experienced a partial return of their symptoms even though the intitial hemodynamic improvements at rest remained evident in all seven patients. Withdrawal of WIN 47203 precipitated hemodynamic deterioration in all patients. The cardiac index decreased from 2.25 ± 0.40 to 1.64 ± 0.46 liters/min per m2 (p < 0.05) while the pulmonary capillary wedge pressure increased from 17.1 ± 7.8 to 23.2 ± 12.0 mm Hg (p < 0.05). Stroke volume index after withdrawal was lower than the control level before therapy (17.0 ± 6.6 versus 20.3 ± 4.7 ml/m2; p < 0.05) and pulmonary capillary wedge pressure was similar. During long-term therapy, no undesirable side effects or hematologic changes were observed. Thus, drug-dependent hemodynamic benefits and apparent progression of the underlying cardiac disease were demonstrated during long-term therapy with WIN 47203.

Original languageEnglish (US)
Pages (from-to)327-331
Number of pages5
JournalJournal of the American College of Cardiology
Volume2
Issue number2
DOIs
StatePublished - 1983

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Cardiotonic Agents
Disease Progression
Pulmonary Wedge Pressure
Hemodynamics
Pharmaceutical Preparations
Therapeutics
Amrinone
Stroke Volume
Heart Diseases
Heart Failure

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Long-term therapy with a new cardiotonic agent, WIN 47203 : Drug-dependent improvement in cardiac performance and progression of the underlying disease. / Sinoway, L. S.; Maskin, C. S.; Chadwick, B.; Forman, Robert; Sonnenblick, E. H.; Le Jemtel, T. H.

In: Journal of the American College of Cardiology, Vol. 2, No. 2, 1983, p. 327-331.

Research output: Contribution to journalArticle

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abstract = "Seven patients with severe chronic congestive heart failure were treated with a new cardiotonic agent, WIN 47203 (an analog of amrinone), for an average of 7.4 weeks (range 2 to 15). At the initiation of therapy, hemodynamic improvement occurred in all patients as the cardiac index increased from 1.79 ± 0.39 to 2.30 ± 0.44 liters/min per m2 (probability [p] < 0.05) and pulmonary capillary wedge pressure decreased from 24.1 ± 6.7 to 16.1 ± 7.8 mm Hg (p < 0.05). Long-term therapy produced a substantial symptomatic improvement in five of the seven patients. This improvement was fully sustained in two patients and the remaining three experienced a partial return of their symptoms even though the intitial hemodynamic improvements at rest remained evident in all seven patients. Withdrawal of WIN 47203 precipitated hemodynamic deterioration in all patients. The cardiac index decreased from 2.25 ± 0.40 to 1.64 ± 0.46 liters/min per m2 (p < 0.05) while the pulmonary capillary wedge pressure increased from 17.1 ± 7.8 to 23.2 ± 12.0 mm Hg (p < 0.05). Stroke volume index after withdrawal was lower than the control level before therapy (17.0 ± 6.6 versus 20.3 ± 4.7 ml/m2; p < 0.05) and pulmonary capillary wedge pressure was similar. During long-term therapy, no undesirable side effects or hematologic changes were observed. Thus, drug-dependent hemodynamic benefits and apparent progression of the underlying cardiac disease were demonstrated during long-term therapy with WIN 47203.",
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