No coin nor oath required. For personal study only.
We studied the effect of a variety of cardiovascular compounds on mechanics and energetics of the left ventricle in patients with idiopathic dilated cardiomypathy NYHA II-III.
In a previous study we have shown that myocardial oxygen consumption correlated best with the systolic stress-time integral (HASENFUSS et al., Circulation 80,(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64). Vasodilators (i.v. nitroprusside and the ACE-inhibitor benazepril) decreased left ventricular pressure and chamber size and thereby proportionally reduced myocardial oxygen consumption. Beta-l-agonists (xamoterol) increase myocardial oxygen consumption with minor changes of the systolic stresstime integral. The effect of phoshodiesterase inhibitors on myocardial oxygen consumption depends on the balance between the energy-consuming positiv-inotropic effect and the energy-saving effect due to vasodilation. The lack of reduction in myocardial oxygen consumption in patients treated with phosphodiesterase inhibitors or beat-1agonists may partially explain why mortality is not decreased in long-term treatment.
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