| Milrinone, dobutamine, and nitroprusside: comparative effects on hemodynamics and myocardial energetics in patients with severe congestive heart failure. | |
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MedLine Citation:
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PMID: 3510773 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To assess their comparative effects on hemodynamics and myocardial energetics, we administered nitroprusside (1.5 +/- 0.6 microgram/kg-min), dobutamine (10 +/- 3 micrograms/kg-min), and milrinone (67 +/- 13 micrograms/kg-min) sequentially to 10 patients with severe (NYHA class III or IV) congestive heart failure. Each agent led to a significant (p = .001) increase in cardiac index (1.9 +/- 0.5 to 2.7 +/- 0.6 liters/min/m2; 1.7 +/- 0.4 to 2.6 +/- 0.6 liters/min/m2; and 1.8 +/- 0.5 to 2.7 +/- 0.5 liters/min/m2, for nitroprusside, dobutamine, and milrinone, respectively). Dobutamine did not produce a significant change in the pulmonary capillary wedge pressure (27 +/- 5 to 24 +/- 6 mm Hg, NS) nor in mean arterial pressure (83 +/- 9 to 86 +/- 10 mm Hg, NS), but caused a significant rise in heart rate (85 +/- 16 to 99 +/- 17 beats/min, p = .001) and in myocardial oxygen consumption (8.7 +/- 2.1 to 11.1 +/- 3.8 ml O2/min, p = .03). In contrast, nitroprusside and milrinone each caused a significant (p = .001) fall in the pulmonary capillary wedge pressure (27 +/- 6 to 19 +/- 7 mm Hg and 26 +/- 6 to 19 +/- 9 mm Hg, respectively), without significantly increasing either the heart rate (87 +/- 18 to 85 +/- 17 beats/min and 86 +/- 17 to 89 +/- 17 beats/min, respectively) or myocardial oxygen consumption (8.8 +/- 2.3 to 7.6 +/- 2.1 ml O2/min and 8.8 +/- 2.1 to 8.4 +/- 2.1 ml O2/min, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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E S Monrad; D S Baim; H S Smith; A S Lanoue |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Circulation Volume: 73 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1986 Mar |
Date Detail:
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Created Date: 1986-03-21 Completed Date: 1986-03-21 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: III168-74 Citation Subset: AIM; IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Clinical Trials as Topic Dobutamine / pharmacology*, therapeutic use Ferricyanides / pharmacology* Heart Failure / drug therapy* Hemodynamics / drug effects* Humans Milrinone Myocardial Contraction / drug effects* Nitroprusside / pharmacology*, therapeutic use Oxygen Consumption / drug effects Pyridones / pharmacology*, therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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HL07374/HL/NHLBI NIH HHS; RR-0001032/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Ferricyanides; 0/Pyridones; 15078-28-1/Nitroprusside; 34368-04-2/Dobutamine; 78415-72-2/Milrinone |
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