| Amrinone versus conventional therapy in pulmonary hypertensive patients awaiting cardiac transplantation. | |
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MedLine Citation:
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PMID: 2818057 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pulmonary hypertension is associated with an increased perioperative mortality for orthotopic heart transplantation. A transpulmonary gradient greater than 15 mm Hg or a pulmonary vascular resistance greater than 5 Woods units increases mortality secondary to right heart failure. This study compares amrinone with conventional therapy in 38 transplant candidates with pulmonary hypertension. All patients had elevated transpulmonary gradient, pulmonary vascular resistance, or both. Group 1 (n = 21) received prolonged continuous intravenous amrinone therapy, whereas group 2 (n = 16) received high-dose oral diuretics, digitalis, and captopril. Both groups 1 and 2 had decreased pulmonary hypertension, transpulmonary gradient, and pulmonary vascular resistance. However, amrinone was more effective, with a 86% response rate versus 63% response for conventional therapy. Survival awaiting transplantation was significantly higher in group 1 (20 of 22, 91%) than in group 2 (10 of 16, 63%). Although both groups 1 and 2 had significantly decreased pulmonary vascular resistance, only group 2 had significantly decreased systemic vascular resistance. Comparison of pulmonary vascular resistance after therapy showed that the response in group 1 (amrinone) was significantly lower than the response in group 2 (conventional therapy), suggesting that amrinone may function as a direct vasodilator of the pulmonary vasculature. There were no operative deaths or episodes of perioperative right heart failure in either group. Amrinone appears to be more effective and safe than conventional therapy in the treatment of prospective heart transplant candidates with pulmonary hypertension. |
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Authors:
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G M Deeb; S F Bolling; T P Guynn; J M Nicklas |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 48 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1989 Nov |
Date Detail:
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Created Date: 1989-12-18 Completed Date: 1989-12-18 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 665-9 Citation Subset: AIM; IM |
Affiliation:
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University of Michigan Medical Center, Ann Arbor. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amrinone / therapeutic use* Angiotensin-Converting Enzyme Inhibitors / therapeutic use Digitalis Glycosides / therapeutic use Diuretics / therapeutic use Female Heart Transplantation* Humans Hypertension, Pulmonary / drug therapy* Male Middle Aged Premedication* Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Digitalis Glycosides; 0/Diuretics; 60719-84-8/Amrinone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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