AR-L 115 improves pump function in patients with advanced and fully treated congestive cardiomyopathy. Since, in spite of such beneficial responses, the energy cost involved might be detrimental when used in advanced coronary artery disease, we monitored clinical haemodynamic and ECG responses to AR-L 115 (2 mg/kg body weight, bolus) in ten patients with coronary artery disease who had developed angina pectoris and/or pathological increases in left ventricular-end diastolic pressure (LVEDP) at the end of a 1 min pacing stress test. 2. When subjected to these stress conditions again (but this time during the peak effect of AR-L 115), there was no longer evidence of ischaemic myocardial impairment, neither clinically by ECG or haemodynamically. 3. There were (average) increase of 43% in cardiac index, 16% in heart rate, 27% in stroke index, 20% in ejection fraction, 31% in VCF and 39% in dp/dt max, while LVEDP decreased to normal values as if at resting conditions. All changes were significant (P less than 0.05). 4. LV-systolic pressure and end diastolic volume (P greater than 0.05) remained the same. Thus the AR-L 115-induced improved LV-pump function was accomplished under stress conditions in the absence of evidence for myocardial ischaemia.
