Separation of the direct myocardial and vasodilator actions of milrinone administered by an intracoronary infusion technique
| Autor: | J. M. O. Arnold, Eugene Braunwald, P L Ludmer, Peter Ganz, Richard F. Wright, Wilson S. Colucci |
|---|---|
| Rok vydání: | 1986 |
| Předmět: |
Adult
Male medicine.medical_specialty Mean arterial pressure Cardiotonic Agents Pyridones Hemodynamics Blood Pressure Norepinephrine Heart Rate Physiology (medical) Internal medicine Heart rate Humans Infusions Intra-Arterial Medicine Aged Heart Failure business.industry Heart Stroke Volume Stroke volume Middle Aged medicine.disease Coronary Vessels Vasodilation medicine.anatomical_structure Heart failure Anesthesia Injections Intravenous Vascular resistance Cardiology Milrinone Female Vascular Resistance Cardiology and Cardiovascular Medicine business Artery medicine.drug |
| Zdroj: | Circulation. 73:130-137 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.73.1.130 |
| Popis: | To determine the relative contributions of milrinone's positive inotropic and vasodilator actions in patients with severe congestive heart failure, the drug was administered by constant infusion directly into the left main coronary artery of 11 patients with New York Heart Association functional class III or IV heart failure. Intracoronary infusion of milrinone at rates up to 50 micrograms/min had no effect on mean arterial pressure or systemic vascular resistance but resulted in dose-related increases in peak positive dP/dt (+21%), stroke volume index (+18%), and stroke work index (+21%) and decreases in heart rate (-3%), mean right atrial pressure (-25%), and left ventricular end-diastolic pressure (-17%). In eight patients, intravenous administration (75 micrograms/kg) after the intracoronary infusion resulted in significant decreases in mean arterial pressure (-14%) and systemic vascular resistance (-40%), further increase in stroke volume index compared with intracoronary administration, and further decreases in mean right atrial and left ventricular end-diastolic pressures compared with intracoronary administration. These data indicate that milrinone exerts both positive inotropic and vasodilator actions that contribute significantly to the drug's overall hemodynamic effect. |
| Databáze: | OpenAIRE |
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