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

Resultado de la investigación: Articlerevisión exhaustiva

47 Citas (Scopus)


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.

Idioma originalEnglish (US)
Páginas (desde-hasta)1331-1336
Número de páginas6
PublicaciónThe American journal of cardiology
EstadoPublished - dic 1 1984
Publicado de forma externa

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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