Tezosentan (an intravenous endothelin receptor A/B antagonist) reduces peripheral resistance and increases cardiac power therefore preventing a steep decrease in blood pressure in patients with congestive heart failure

Gad Cotter, Wolfgang Kiowski, Edo Kaluski, Isaac Kobrin, Olga Milovanov, Alon Marmor, Jamal Jafari, Leonardo Reisin, Ricardo Krakover, Zvi Vered, Avi Caspi

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Objective: This study investigated the effect of tezosentan (an intravenous endothelin-1 receptor antagonist) on vascular resistance and cardiac function and determined the dose response in patients with stable congestive heart failure (CHF) due to left ventricular systolic dysfunction. Methods: In a double-blind fashion, tezosentan or placebo were administered in ascending doses (5, 20, 50, 100 mg h-1) to 38 CHF (NYHA class III) patients with ejection fraction ≥ 35%, cardiac index ≤ 2.7 1 min-1 m-2 and pulmonary capillary wedge pressure ≥ 15 mmHg. Systemic vascular resistance index (SVRi) was estimated as mean arterial blood pressure [(MAP-right atrial pressure) ÷ cardiac index (CI)]. Cardiac function was assessed as cardiac power index (Cpi), calculated as pressure × flow (MAP × CI), where MAP represents pressure and CI represents cardiovascular flow. Results and discussion: Compared to the placebo, tezosentan induced a dose-dependent decrease in SVRi (-32%), an increase in Cpi (+20%) and a small decrease in MAP (-9%). By contrast, patients treated with nitrate vasodilators or nesiritide (a natriuretic peptide) showed a decrease in SVRi not accompanied by a significant increase in Cpi leading to a steep decrease in MAP. Conclusions: The use of Cpi in the assessment of the hemodynamic effects of tezosentan, provides a useful alternative characterization of the complex influences of vasodilators on cardiac function in patients with CHF.

Original languageEnglish
Pages (from-to)457-461
Number of pages5
JournalEuropean Journal of Heart Failure
Volume3
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Blood pressure
  • Congestive heart failure
  • Tezosentan

Fingerprint

Dive into the research topics of 'Tezosentan (an intravenous endothelin receptor A/B antagonist) reduces peripheral resistance and increases cardiac power therefore preventing a steep decrease in blood pressure in patients with congestive heart failure'. Together they form a unique fingerprint.

Cite this