The acute hemodynamic effects of the
phosphodiesterase (PDE) III inhibitor
saterinone were compared with
dobutamine and
sodium nitroprusside in 12 patients with idiopathic
congestive cardiomyopathy (NYHA III). Hemodynamic measurements were obtained with a Swan-Ganz thermodilution
catheter. At the peak of its dose-response curve,
saterinone induced an increase in cardiac index (+102%), stroke volume (+97%), and heart rate (+6%), paralleled by a decrease in pulmonary capillary wedge pressure (-46%), right atrial pressure (-51%), pulmonary arterial pressure (systolic -32%, diastolic -45%, mean -38%), systemic blood pressure (systolic -3%, diastolic -13%, mean -9%), systemic vascular resistance (-54%), and pulmonary vascular resistance (-58%).
Dobutamine had similar effects on cardiac index (+106%) and stroke volume (+87%) but lacked vasodilatory characteristics. In contrast to
dobutamine, both
nitroprusside and
saterinone demonstrated more pronounced vasodilatory effects.
Nitroprusside was less effective on cardiac index (+66%) and stroke volume (+56%) than was
saterinone. The double product was markedly increased by
dobutamine (+28%), did not change with
saterinone treatment (+2%), and decreased with
nitroprusside (-10%). This indicates that according to double product, only the application of
dobutamine caused a relevant increase in myocardial oxygen consumption.
Saterinone was demonstrated to be a safe and potent
drug on short-term application; it combines the vasodilating properties of
sodium nitroprusside with the positive inotropic effects of
dobutamine without major changes in myocardial oxygen consumption.