Haemodynamic effects of carbochromen.

Carbochromen increases coronary flow and cardiac output. A previous study has advanced the hypothesis that the latter may be due to afterload reduction. Fourteen patients with coronary heart disease have now been studied by means of radionuclide angiocardiography. Gated blood pool angiocardiographic data were collected in basal conditions and, without moving the patient, 80 mg of carbochromen were administered i.v. Data were collected again, following infusion, during 3'-6'(1) and 7'-10'(2) periods. Changes in the following parameters have been evaluated: LV ejection fraction (EF), LV ejection rate (ER), system pressure (BP), heart rate (HR), cardiac output index (CO), stroke volume index (SV), LV end-diastolic volume index (EDV), systemic vascular resistance index (SVR), regional LV wall motion. During period 1 a significant decrease was observed in BP and SVR, the other parameters remaining unchanged. During period 2 there was a significant increase in CO, SV, EF, ER and a significant decrease in SVR. BP was unchanged. No changes were ascertained in HR and EDV. Eight patients, in basal conditions, showed asynergy in the LAO projection. Three of these patients showed improved wall motion during period 2. A possible central action of carbochromen should be pointed out. This conclusion can be drawn by observing the increase in the pump indexes, while BP and SVR show a decrease and EDV and HR no change. The left ventricular wall motion improvement observed in some of the cases confirms the possibility that carbochromen is capable of improving cardiac contractility. This effect may follow the regional myocardial perfusion increase.