Document Detail


Amrinone increases ventricular contractility and diastolic compliance in endotoxemia.
MedLine Citation:
PMID:  7633698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Systolic and diastolic dysfunction occur during human septic shock, and sensitivity to beta-adrenergic agents is reduced. We sought to determine whether amrinone, an inotropic agent independent of beta-receptors, increases left-ventricular contractility or diastolic compliance after endotoxin infusion. We measured left-ventricular volume (using a conductance catheter) and pressure (using a Millar catheter) before and after administering amrinone (4.5 mg/kg i.v., then 10 micrograms/kg/min) to six endotoxemic and seven control pigs. The slope of the end-systolic pressure-volume relationship, Ees, was used as the primary measure of contractility. Diastolic stiffness was characterized using stiffness parameters taken from pressure-volume relationships (k) and from pressure-volume strain relationships. Amrinone increased Ees from a median of 10.4 mm Hg/ml (interquartile range, 7.2 to 12.3) to 16.4 (13.7 to 18.6) (p < 0.05) in the endotoxin group (p < 0.05). Amrinone decreased diastolic stiffness (k) in the endotoxin group by 35 +/- 18% (p < 0.05). Amrinone did not significantly change Ees or k in the control group. Mean arterial pressure decreased after endotoxin infusion from 117 +/- 23 mm Hg to 76.5 +/- 14.9 mm Hg (p < 0.05), and decreased further after amrinone to 62.0 +/- 14.8 mm Hg (p < 0.05). We conclude that in this model of sepsis, amrinone may beneficially increase systolic contractility and diastolic compliance, but may dangerously decrease an already low mean arterial pressure.
Authors:
H A Werner; M J Herbertson; K R Walley
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  152     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-09-14     Completed Date:  1995-09-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  496-503     Citation Subset:  AIM; IM    
Affiliation:
Pulmonary Research Laboratory, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
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MeSH Terms
Descriptor/Qualifier:
Amrinone / pharmacology*
Animals
Atrial Function, Right / drug effects
Blood Pressure / drug effects
Cardiac Output / drug effects
Cardiac Volume / drug effects
Coronary Circulation / drug effects
Diastole
Elasticity
Endotoxins / blood*
Escherichia coli
Heart Catheterization
Heart Rate / drug effects
Myocardial Contraction / drug effects*
Oxygen / blood
Shock, Septic / physiopathology*
Stroke Volume / drug effects
Swine
Systole
Ventricular Function, Left / drug effects*
Ventricular Pressure / drug effects
Chemical
Reg. No./Substance:
0/Endotoxins; 60719-84-8/Amrinone; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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