Effects of calcitonin gene-related peptide on cardiac contractility, coronary hemodynamics and myocardial energetics in idiopathic dilated cardiomyopathy.
This study was performed to examine the effects of calcitonin gene-related peptide on cardiac function and coronary circulation in patients with heart failure. Synthetic human calcitonin gene-related peptide was infused in the left main coronary artery of 9 patients undergoing cardiac catheterization at different doses corresponding to incremental infusion rates of 15, 50, 150 and 600 pmol.min-1. No hemodynamic change was observed in response to administration of the 2 lowest doses. The 2 highest doses induced an increase in cardiac index and a decrease in systemic arterial pressure. The infusion of 600 pmol.min-1 resulted in a decrease of mean systemic arterial pressure (86.8 +/- 6.5 to 71.8 +/- 4.9 mm Hg; p less than 0.01), and an increase in both cardiac index (2.1 +/- 0.1 to 3.1 +/- 0.17 liters.min-1.m-2; p less than 0.01) and heart rate (87 +/- 3.7 to 101 +/- 6.1 beats.min-1; p less than 0.01). These hemodynamic changes were associated with a significant increase in plasma norepinephrine and epinephrine concentrations. Peak positive first derivative of left ventricular pressure did not change at any infusion rate. Left ventricular end-diastolic pressure decreased at the 2 highest doses associated with a decrease in plasma atrial natriuretic factor concentration (730 +/- 140 to 436 +/- 115 pg.ml-1; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Dubois-Randé
J L
JL
Departement de Cardiologie et de Physiologie, Hopital Henri Mondor, Creteil, France.
Merlet
P
P
Benvenuti
C
C
Sediame
S
S
Macquin-Mavier
I
I
Chabrier
E
E
Braquet
P
P
Castaigne
A
A
Adnot
S
S
D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood; D015740:Calcitonin Gene-Related Peptide / Q000494:pharmacology*; D002311:Cardiomyopathy, Dilated / Q000378:metabolism / Q000503:physiopathology*; D002395:Catecholamines / Q000097:blood; D003326:Coronary Circulation / Q000187:drug effects*; D004280:Dobutamine / Q000494:pharmacology; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007773:Lactates / Q000097:blood; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*; D009206:Myocardium / Q000378:metabolism*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000187:drug effects
D002395:Catecholamines; D007773:Lactates; D004280:Dobutamine; D009320:Atrial Natriuretic Factor; D015740:Calcitonin Gene-Related Peptide; D010100:Oxygen