Assessment of the inotropic and vasodilator effects of amrinone versus isoproterenol

Brian G. Firth, Adam V. Ratner, Eric D. Grassman, Michael D. Winniford, Pascal Nicod, L. David Hillis

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

The hemodynamic effects of graded-dose infusions of amrinone (maximal dose 30 μg/kg/min) (10 patients) and isoproterenol (maximum dose 4 μg/min) (11 patients) were assessed in patients with a range of left ventricular (LV) function. LV rejection 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 < 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 <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 <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 <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.

Original languageEnglish (US)
Pages (from-to)1331-1336
Number of pages6
JournalThe American Journal of Cardiology
Volume54
Issue number10
DOIs
StatePublished - Dec 1 1984
Externally publishedYes

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Amrinone
Vasodilator Agents
Isoproterenol
Cardiac Output
Vascular Resistance
Ventricular Pressure
Heart Rate
Arterial Pressure
Cardiac Volume
Left Ventricular Function
Stroke Volume
Hemodynamics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Firth, B. G., Ratner, A. V., Grassman, E. D., Winniford, M. D., Nicod, P., & Hillis, L. D. (1984). Assessment of the inotropic and vasodilator effects of amrinone versus isoproterenol. The American Journal of Cardiology, 54(10), 1331-1336. https://doi.org/10.1016/S0002-9149(84)80092-2

Assessment of the inotropic and vasodilator effects of amrinone versus isoproterenol. / Firth, Brian G.; Ratner, Adam V.; Grassman, Eric D.; Winniford, Michael D.; Nicod, Pascal; Hillis, L. David.

In: The American Journal of Cardiology, Vol. 54, No. 10, 01.12.1984, p. 1331-1336.

Research output: Contribution to journalArticle

Firth, BG, Ratner, AV, Grassman, ED, Winniford, MD, Nicod, P & Hillis, LD 1984, 'Assessment of the inotropic and vasodilator effects of amrinone versus isoproterenol', The American Journal of Cardiology, vol. 54, no. 10, pp. 1331-1336. https://doi.org/10.1016/S0002-9149(84)80092-2
Firth, Brian G. ; Ratner, Adam V. ; Grassman, Eric D. ; Winniford, Michael D. ; Nicod, Pascal ; Hillis, L. David. / Assessment of the inotropic and vasodilator effects of amrinone versus isoproterenol. In: The American Journal of Cardiology. 1984 ; Vol. 54, No. 10. pp. 1331-1336.
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