Hemodynamic, Echocardiographic, and Neurohormonal Effects of Istaroxime, a Novel Intravenous Inotropic and Lusitropic AgentA Randomized Controlled Trial in Patients Hospitalized With Heart Failure
Mihai Gheorghiade, MD, FACC*,*,
John E.A. Blair, MD*,
Gerasimos S. Filippatos, MD, FACC ,
Cezar Macarie, MD ,
Witold Ruzyllo, MD ,
Jerzy Korewicki, MD,
Serban I. Bubenek-Turconi, MD¶,
Maurizio Ceracchi, MS||,
Maria Bianchetti, PhD||,
Paolo Carminati, MD||,
Dimitrios Kremastinos, MD,
Giovanni Valentini, MD||,
Hani N. Sabbah, PhD, FACC# for the HORIZON-HF Investigators
* Feinberg School of Medicine, Northwestern University, Chicago, Illinois
University Hospital Attikon, Athens, Greece
National Institute of Cardiovascular Disorders, Bucharest, Romania
National Institute of Cardiology, Warsaw, Poland
¶ CC Iliescu Heart Diseases Institute, Bucharest, Romania
|| Sigma-Tau, Pomezia (Rome), Italy
# Department of Medicine, Henry Ford Hospital, Detroit, Michigan.
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Figure 1 Enrollment
*The imbalance in number of patients (29 instead of 30 in the 0.5 µg/kg/min group) is due to an assignment error. INR = International Normalized Ratio for Prothrombin Time; PCWP = pulmonary capillary wedge pressure.
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Figure 2 Invasive Hemodynamics Over the Course of Infusion
Pulmonary capillary wedge pressure (PCWP), cardiac index (CI), mean right atrial pressure (RAP), and stroke work index (SWI), plotted over the time course of treatment with placebo (purple) or istaroxime 0.5 µg/kg/min (blue), 1.0 µg/kg/min (red), and 1.5 µg/kg/min (green). The p values refer to the main effect, by repeated-measures analysis.
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Figure 3 Noninvasive Hemodynamic Parameters Over the Course of Infusion
Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR), plotted over the time course of treatment with placebo (purple) or istaroxime 0.5 µg/kg/min (blue), 1.0 µg/kg/min (red), and 1.5 µg/kg/min (green). The p values refer to the main effect, by repeated-measures analysis.
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Figure 5 Left Ventricular Volumes After Infusion
The p values refer to the comparison of each dose versus placebo. LVEDV = left ventricular end-diastolic volume; LVEF = left ventricular ejection fraction; LVESV = left ventricular end-systolic volume.
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