Hemodynamic effects of intravenous pirmenol.

The hemodynamic effects of intravenous pirmenol were studied in 21 subjects instrumented with peripheral arterial, pulmonary artery, and left ventricular catheters. Baseline measurements of heart rate, cardiac output, pulmonary artery pressure, systemic arterial pressure, left ventricular end-diastolic pressure, left ventricular stroke work, and ejection fraction were obtained. An infusion of pirmenol hydrochloride was administered and hemodynamic measurements were repeated an average of 16.1 minutes following the start of the infusion after a new stable hemodynamic state was achieved. Significant increases in heart rate and systemic arterial pressure were noted. There were no significant changes in cardiac output, pulmonary arterial pressure, or left ventricular end-diastolic pressure. Significant reductions in left ventricular stroke work and ejection fraction were demonstrated. The amount of decrease in the ejection fraction was not related to the plasma pirmenol level achieved or to the baseline level of ventricular function. These findings suggest a negative inotropic effect of acute infusions of pirmenol and suggest caution should be used in its administration to patients with compromised left ventricular performance.