international Journal of Cardiology, 29 (1990) 229-237 Elsevier 229 CARD10 01138 Effects of the inotrope DPI 201406 on cardiac performance following cardiac surgery M.E. Davis *, R.O. Feneck ‘, C.J.H. Jones 2, M.W. Lunnon ’ and R.K. Walesby 4 Depariments of ’ Anaesthesia, ’ Cardiology and ’ Cardrothoracic Surgerv, The London Chest Hospital. London. 4 Clinical Research Unit London, Sando: Limrted. Fehham, U.K. (Received 14 December 1989; revision accepted 14 May 1990) Davis ME, Feneck RO, Jones CJH, Lunnon MW, Walesby RK. Effects of the inotrope DPI 201-106 on cardiac performance following cardiac surgery. Int J Cardiol 1990;29:229-237. zyxwvutsrqponmlkjihgfedcbaZYXWVU The haemodynamic, cardiac metabolic and electrocardiographic effects of the intravenous inotropic agent DPI 201-106, in 20 and 40 milligram doses, were studied in patients after coronary arterial bypass grafting. The patients were randomly allocated to receive placebo or DPI 201-106. Those receiving the active drug received either the 20 or the 40 mill&am dosages of DPI 201-106. Both the placebo and the active drug were infused over 20 minute periods. Two baseline readings confirmed haemodynamic stability, and readings were taken immediately following the infusions and then at 20 minutes and at 40 minutes afterwards. Comparison of all the haemodynamic and metabolic data did not reveal any significant intra or inter group differences. Comparison of the electrocardiographic data revealed some differences. Patients receiving DPI 201-106 showed prolongation of the QTc interval immediately following the infusions. Changes in ST segments and T waves were observed. Independent analysis of the affected electrocardiographs reported that the changes were suggestive of, but not pathognomonic of, myocardial ischaemia. The metabolic data showed that the electrocardiographic changes were not associated with any evidence of anaerobic metabolism. The indication for DPI 201-106 as a positive inotropic agent in patients following coronary revascularization surgery was not established. Key words: DPI 201-106; Inotropic action; Electrocardiograph: Coronary surgery Introduction The observation that many patients demon- strate an increase in systemic vascular resistance Correspondence fo: Dr. R.O. Feneck, Dept. of Anaesthetics. The London Chest Hospital, Banner Road, London E2 9JY. U.K. following cardiac surgery has led to the widespread use of vasodilators in this situation [l--3]. A num- ber of patients, however. also demonstrate a mild degree of biventricular failure following cardio- pulmonary bypass, necessitating positive inotropic support as well as arteriolar vasodilation if early recovery is to be achieved. DPI 201-106 is a piperazinyl-indole derivative which has shown potential as a positive inotropic agent in patients Supported by a grant from Sandoz Limited. Feltham. Mid- with congestive cardiomyopathy or chronic con- dlesex, U.K. gestive heart failure [4,5]. but there are no data 0167-5273/90/$03.50 4’ 1990 Elsevier Science Publishers B.V. (Biomedical Division)