Hemodynamic effects of fructose 1,6-diphosphate in patients with normal and impaired left ventricular function,

We compared the short-term hemodynamic effects of intravenous fructose 1,6-diphosphate (FDP) administration in patients with coronary artery disease. Hemodynamic measurements were performed before and after administration of FDP in two groups of patients: those with impaired left ventricular (LV) function, elevated LV end-diastolic pressures (LVEDP ≥12 mm Hg, n = 30), and those with normal LV function (LVEDP <12 mm Hg, n = 17). In those with impaired LV function, FDP induced a decrease in LVEDP from 22 ± 1.31 to 16.73 ± 1.46 mm Hg ( p < 0.0001). The cardiac index increased (2.50 ± 0.11 to 2.81 ± 0.13 L/m 2 [ p < 0.0001]), as did the LV stroke work index (31.7 ± 2.04 to 40.3 ± 2.67 gm • m • m 2 [ p < 0.0001]). FDP induced no significant change in heart rate and mean aortic pressure. Pulmonary pressure and resistance declined ( p < 0.002 and p < 0.0001, respectively). Systemic vascular resistance decreased because of increased cardiac output and unchanged arterial pressure ( p < 0.001). In those patients with normal baseline LVEDP (5.06 ± 0.27 mm Hg), FDP decreased heart rate ( p < 0.0001) and systemic and pulmonary resistance ( p < 0.03 and p < 0.004, respectively), whereas LVEDP and mean aortic and pulmonary pressures remained unchanged. FDP moderately increased cardiac output ( p < 0.05), stroke volume index, and LV stroke work index ( p < 0.002 and p < 0.003, respectively). The observed improvement in LV function in those patients with elevated LV filling pressures is thought to be a result of an increased energy production by the Embden-Meyerhoff pathway and to act as a positive inotrope. (Am Heart J 1997;133:541-9.)