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 language | English (US) |
|---|---|
| Pages (from-to) | 1331-1336 |
| Number of pages | 6 |
| Journal | The American Journal of Cardiology |
| Volume | 54 |
| Issue number | 10 |
| DOIs | |
| State | Published - Dec 1 1984 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - Assessment of the inotropic and vasodilator effects of amrinone versus isoproterenol
AU - Firth, Brian G.
AU - Ratner, Adam V.
AU - Grassman, Eric D.
AU - Winniford, Michael D.
AU - Nicod, Pascal
AU - Hillis, L. David
PY - 1984/12/1
Y1 - 1984/12/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0021716029&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0021716029&partnerID=8YFLogxK
U2 - 10.1016/S0002-9149(84)80092-2
DO - 10.1016/S0002-9149(84)80092-2
M3 - Article
C2 - 6507308
AN - SCOPUS:0021716029
VL - 54
SP - 1331
EP - 1336
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 10
ER -