[Cardiac performance and hemodynamic response under the effect of isoproterenol and D-isosorbitol in patients with dilated cardiomyopathy]. / Desempenho cardíaco e resposta hemodinâmica sob ação do isoproterenol e D-isosorbitol em portadores de miocardiopatia dilatada.

ABSTRACT

The authors studied cardiac performance of 36 patients with dilated cardiomiopathy through cardiac catheterization and left ventriculography in comparison with a control group. It has been verified that the end systolic volume (ESV) is more sensitive than ejection fraction (EF) as an indicator of the presence and degree of systolic dysfunction. Isoproterenol (IP) (18 patients) and D-isosorbitol (IS) (18 patients) have been used in the evaluation of hemodynamic response of DM. It has been verified equivalent responses such as 1--decrease of ESV and end diastolic pressure (EDP); 2--increase of stroke volume and EF. The contractility indexes of left ventricle, however, showed different responses to the 2 substances 1--with IP there was an increase of peak dp/dt and common peak isovolumetric pressure (CPIP 45 mmHg); 2--with IS there was no variation. The authors conclude that 1--IP or similar drugs may be used during cardiac catheterization to evaluate the contractile reserve of the myocardium; 2--IS may be used in ambulatorial treatment of DM to improve ventricular function through a tendency to normalize intracardiac pressure-volume relation.