Acute haemodynamic and myocardial metabolic effects of intravenous urapidil in severe heart failure.

The acute haemodynamic and myocardial metabolic effects of intravenous urapidil were evaluated in 12 patients with severe congestive heart failure due to coronary heart disease. Urapidil was given intravenously (0.5 mg kg-1 min-1 as a bolus) followed by infusion at a rate of 4 micrograms kg-1 min-1 for 120 min. Following urapidil administration, cardiac index increased by 29%, mean pulmonary artery wedge pressure fell by 35% and systemic vascular resistance by 33%. The fall in mean arterial pressure was moderate. No significant alterations in coronary sinus blood flow, myocardial oxygen consumption and myocardial lactate extraction occurred. No untoward effect was observed. This study shows that intravenous urapidil produces beneficial haemodynamic effects without a deleterious effect on myocardial metabolism in patients with heart failure due to coronary heart disease.