Cardiovascular effects of a new inotropic agent, denopamine (TA-064) ; With reference to it's effects on cardiac hemodynamics and metabolism.

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A new inotropic agent, denopamine (TA-064) was shown to have a strong positive inotropic effect. Its effect on cardiac hemodynamics and metabolism was evaluated by using wall stress and direct measurement of myocardial oxygen consumption. With plasma concentration of denopamine (21-29 ng/ml on average), attainable by one single oral dose (10 mg), the positive inotropic effect was evident by the significant increase in peak (+) dp/dt (+15% increase from control), and shortening velocity of the left ventricle (+39%), when heart rate or blood pressure was not altered significantly. End-diastolic stress and endsystolic stress of the left ventricle, defined as indices of preload and afterload, respectively, were reduced significantly. The reduction of preload (-51%) was the result of improved left ventricular filling, and the reduction of afterload (-23%) was due to the increased contractility. Neither coronary sinus blood flow nor aortocoronary AV O2 defference was changed. Consequently, myocardial oxygen consumption remained unaltered. When the dose is chosen properly, denopamine is able to exert salutary effects in patients with severe heart failure.

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