PROSTAGLANDIN E-1 INFUSION COMPARED WITH PROSTACYCLIN INFUSION IN PATIENTS WITH REFRACTORY HEART-FAILURE - EFFECTS ON HEMODYNAMICS AND NEUROHUMORAL VARIABLES

Prostaglandin E-1 or prostacyclin were randomly infused in 18 patients with severe chronic heart failure who did not respond to oral treatme nt. Maximally tolerated dosages of both agents increased cardiac index ; however, only prostacyclin decreased mean arterial pressure and incr eased plasma norepinephrine significantly. Twelve hours after 50% peak dose reduction, atrial natriuretic peptide levels, right atrial press ure, mean pulmonary artery pressure, and mean arterial pressure contin ued to decrease with prostaglandin E-1, whereas the increase in cardia c index was sustained; in contrast, at 50% prostacyclin dose reduction , cardiac index decreased toward baseline, suggesting that, with reduc ed dosages for chronic infusions, desired hemodynamic changes seem to be sustained with prostaglandin E-1 only.