Document Detail


Assessment of the inotropic and vasodilator effects of amrinone versus isoproterenol.
MedLine Citation:
PMID:  6507308     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The hemodynamic effects of graded-dose infusions of amrinone (maximal dose 30 micrograms/kg/min) (10 patients) and isoproterenol (maximum dose 4 micrograms/min) (11 patients) were assessed in patients with a range of left ventricular (LV) function. LV ejection fraction ranged from 0.13 to 0.77 (mean +/- standard deviation 0.47 +/- 0.23) among the patients who received amrinone and from 0.24 to 0.77 (mean 0.52 +/- 0.18) among those who received isoproterenol. Peak-dose amrinone produced a reduction in LV filling pressure (from 15 +/- 10 to 10 +/- 7 mm Hg, p less than 0.001), but no significant change in heart rate, cardiac output, mean aortic pressure, total systemic vascular resistance (TSVR) or LV dP/dt max. In contrast, peak-dose isoproterenol produced a similar reduction in LV filling pressure (from 17 +/- 12 to 13 +/- 13 mm Hg, p less than 0.05), but also caused increases in heart rate, cardiac output and LV dP/dt max and decreases in mean aortic pressure and TSVR (p less than 0.001). The absolute change in cardiac output and stroke volume correlated closely with the change in TSVR in response to amrinone (r = -0.90, p less than 0.001 and r = -0.84, p = 0.002, respectively), but not in response to isoproterenol. Although isoproterenol produced a marked increase in cardiac output and LV dP/dt max (not explained by heart rate changes alone) in all patients, amrinone produced an increase in cardiac output only in those with markedly elevated LV filling pressures (who had a reduction in TSVR), and an increase in LV dP/dt in a minority.
Authors:
B G Firth; A V Ratner; E D Grassman; M D Winniford; P Nicod; L D Hillis
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  54     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1984 Dec 
Date Detail:
Created Date:  1984-12-26     Completed Date:  1984-12-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1331-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aminopyridines / administration & dosage,  pharmacology*
Amrinone
Blood Pressure / drug effects
Cardiac Output / drug effects
Cardiotonic Agents / administration & dosage,  pharmacology*
Dose-Response Relationship, Drug
Heart Catheterization
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Isoproterenol / administration & dosage,  pharmacology*
Pulmonary Wedge Pressure / drug effects
Stroke Volume / drug effects
Vascular Resistance / drug effects
Vasodilator Agents / administration & dosage,  pharmacology*
Chemical
Reg. No./Substance:
0/Aminopyridines; 0/Cardiotonic Agents; 0/Vasodilator Agents; 60719-84-8/Amrinone; 7683-59-2/Isoproterenol

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


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