Secretin infusion in acute ischemic left ventricular failure: effects on myocardial performance and metabolism in a closed-chest dog model.

Acute ischemic left ventricular (LV) failure in eight closed-chest, anesthetized dogs was induced by embolization of the left coronary artery with 50 micron polystyrene microspheres until LV end-diastolic pressure reached 25.2 +/- 1.4 mm Hg. Cardiac output was reduced by 33%, LVdP/dt by 32% and mean arterial pressure fell substantially. Plasma secretin increased significantly during the induction of failure. Infusion of secretin, 16 clinical units X kg-1 X hr-1 caused a persistent increment in LV performance, due to arteriolar dilation as well as a modest inotropic effect. Heart rate was elevated slightly and LV end-diastolic pressure unchanged. Mean arterial pressure was unchanged initially, but decreased slightly at the end of the infusion period. Myocardial oxygen consumption was unaltered. It is concluded that secretin may be well suited for the treatment of acute LV failure.