Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Amrinone”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources
PubMed1983

Amrinone therapy for congestive heart failure in outpatients with idiopathic dilated cardiomyopathy.

Amrinone, 100 mg orally every 8 hours, was administered to 13 patients with moderate-to-severe congestive heart failure (CHF) for 1 month on an outpatient basis to determine the beneficial and undesirable effects of this new cardioactive agent in this clinical setting. These subjects received conventional CHF medications during the course of study. Ten patients who received conventional CHF medications alone served as a control group. Changes in functional classification were not significantly different between the 2 treatment groups. Amrinone augmented exercise capacity 37% above baseline compared with a 12% improvement for the control group. Noninvasive indexes of resting left ventricular function (echocardiography and systolic time intervals) did not change significantly for either group, nor was there a significant change in the exercise ejection fraction. All patients treated with amrinone had greater than or equal to 1 symptom-related or laboratory-detected adverse effect. An increase in the frequency of ventricular ectopic beats was noted at rest in 4 and with exercise in 6 patients (salvos of nonsustained ventricular tachycardia in 2). Six subjects treated with amrinone had gastrointestinal symptoms and 8 developed a viral-like illness. Other adverse effects noted in the amrinone-treated group included near-syncope, headaches, marked anxiety, chest pain, palpitations, maculopapular rash, hypokalemia, and elevation of serum transaminase levels. The control patients had significantly fewer adverse effects. Although individual patients with CHF may benefit from long-term amrinone therapy, the low benefit-to-risk-adverse effect ratio does not warrant widespread application of this drug in the outpatient management of CHF and requires caution when prescribing.

Aminopyridines↗
PubMed1989

Amrinone versus conventional therapy in pulmonary hypertensive patients awaiting cardiac transplantation.

Pulmonary hypertension is associated with an increased perioperative mortality for orthotopic heart transplantation. A transpulmonary gradient greater than 15 mm Hg or a pulmonary vascular resistance greater than 5 Woods units increases mortality secondary to right heart failure. This study compares amrinone with conventional therapy in 38 transplant candidates with pulmonary hypertension. All patients had elevated transpulmonary gradient, pulmonary vascular resistance, or both. Group 1 (n = 21) received prolonged continuous intravenous amrinone therapy, whereas group 2 (n = 16) received high-dose oral diuretics, digitalis, and captopril. Both groups 1 and 2 had decreased pulmonary hypertension, transpulmonary gradient, and pulmonary vascular resistance. However, amrinone was more effective, with a 86% response rate versus 63% response for conventional therapy. Survival awaiting transplantation was significantly higher in group 1 (20 of 22, 91%) than in group 2 (10 of 16, 63%). Although both groups 1 and 2 had significantly decreased pulmonary vascular resistance, only group 2 had significantly decreased systemic vascular resistance. Comparison of pulmonary vascular resistance after therapy showed that the response in group 1 (amrinone) was significantly lower than the response in group 2 (conventional therapy), suggesting that amrinone may function as a direct vasodilator of the pulmonary vasculature. There were no operative deaths or episodes of perioperative right heart failure in either group. Amrinone appears to be more effective and safe than conventional therapy in the treatment of prospective heart transplant candidates with pulmonary hypertension.

Adult↗
PubMed1987

The role of calcium in amrinone action on intestinal smooth muscle.

In the guinea-pig isolated ileum amrinone (3 microM to 0.3 M) induced transient, dose-dependent contractions which were followed by pronounced relaxation only at the highest amrinone concentrations tested (30 mM to 0.3 M). The contractile effect was potentiated by eserine and abolished by scopolamine. Verapamil, at concentrations (0.1-1 microM) that did not affect basal tension of the preparations or the contractile response to exogenous acetylcholine, selectively reduced amrinone-evoked contraction, while the relaxing component was abolished by verapamil concentrations (5-10 microM) that per se reduced muscle tension as well as acetylcholine-induced contraction. Similarly, when external Ca2+ concentration was reduced from 2.5 to 1.25 and 0.5 mM, the contractile component of amrinone effect was markedly reduced, while relaxation was not significantly altered. Any further decrease of Ca2+ content in the superfusion medium (0.25 to 0 mM) also reduced the relaxing effect of amrinone and the response of the ileum to exogenous acetylcholine. The present results indicate that in guinea-pig ileum amrinone-induced contractions are sustained by acetylcholine release as well as by Ca2+ entry into smooth muscle cells through verapamil-sensitive channels, while other Ca2+ pools may play a role in the relaxing effect of the drug.

Acetylcholine↗
PubMed1989

The role of amrinone in potential heart transplant patients with pulmonary hypertension.

Orthotopic heart transplantation is contraindicated in patients with pulmonary hypertension and an elevated pulmonary vascular resistance. In an attempt to make otherwise unacceptable patients possible candidates for heart transplantation, amrinone was administered intravenously to 27 individuals with a transpulmonary gradient and pulmonary vascular resistance in the abnormal range. Twenty-four of 27 patients (89%) responded positively. Twenty-one of 27 (78%) went on to transplantation and 20 of 21 (95%) survived the procedure. A second study compared amrinone therapy with conventional therapy in 38 potential transplant candidates with pulmonary hypertension. Amrinone was more effective in reducing pulmonary hypertension than conventional therapy with high-dose diuretics, digitalis, and captopril (86% v 63%). Survival rate of those awaiting transplantation was also significantly higher in the amrinone group (91% v 63%). Although the protocol for comparing the two regimens does not allow for extrapolation of the results (amrinone was administered in-hospital under close monitoring, whereas conventional therapy was self-administered at home), the findings confirm the clinical impression that amrinone seems more effective and safer than conventional therapy in the treatment of potential heart transplant patients with pulmonary hypertension.

Amrinone↗
PubMed1993

Hemodynamic effects of amrinone and colloid administration in children following cardiac surgery.

Amrinone was used as the sole vasoactive medication in 9 of 14 children (aged 5 months to 8.25 years) given the drug following open repair of congenital cardiac lesions. Four children received a concomitant dopamine infusion and one infant had the infusion stopped after 5 hours for low mean arterial pressure (49 mmHg). In the 10 children receiving only amrinone, cardiac index increased 21% (range, 0 to 94%) after a total loading dose of 4.5 mg/kg given over 1 hour. Four of 14 patients (29%) required dopamine infusions to maintain mean arterial pressure over 55 mmHg and in these children cardiac index increased from baseline and was maintained during the amrinone infusion. Preload was held constant by administration of whole blood or plasmanate during amrinone loading; a decrease in systemic vascular resistance index was seen resulting in a stable arterial blood pressure. Minimal chronotropic effect was seen and no arrhythmias occurred. The sole child with postoperative pulmonary hypertension had a beneficial decrease in pulmonary artery pressure, increase in cardiac index, and stable systemic blood pressure during amrinone use. Cardiac index changes during amrinone loading in these children were variable and less clearly related to serum levels than reported in adults. Pharmacokinetic analysis in 12 children showed a clearance of 3.4 mL/min/kg, a volume of distribution of 1.65 L/kg, and an elimination half-life of 5.75 hours. Decreases in platelet counts were seen in 6 children and platelet transfusion was needed in 1; thus, serial platelet counts should be monitored.(ABSTRACT TRUNCATED AT 250 WORDS)

Amrinone↗
PubMed1994

An amrinone bolus prior to weaning from cardiopulmonary bypass improves cardiac function in mitral valve surgery patients.

This double-blind, randomized study was performed to assess the effectiveness of a single bolus dose of 2 mg/kg of amrinone given during cardiopulmonary bypass (CPB) to patients undergoing mitral valve surgery. Outcome variables were hemodynamic function and the number and amount of vasopressors or inotropes required to wean from CPB. In amrinone-treated patients, cardiac index (CI) increased significantly by 48 +/- 14% following CPB (T3) versus 10 +/- 10% for placebo-treated patients (P = 0.029). Similarly, on arrival in the intensive care unit (T4), CI was increased by 52 +/- 20% in amrinone patients versus 8 +/- 8% for placebo patients (P = 0.04). There was a corresponding decrease in systemic vascular resistance index of 47 +/- 6% at T3 in the amrinone patients versus 10 +/- 14% in placebo patients (P = 0.001), and a decrease of 30 +/- 7% at T4 versus an increase of 10 +/- 22% for the placebo patients (P = 0.036). There was no difference in other measured hemodynamic variables. While on CPB, mean arterial pressure at 5 minutes following administration of the study drug was decreased in amrinone patients by 20 +/- 4% versus 4 +/- 3% in placebo patients (P = 0.005), but was no different at 10 and 15 minutes. There were no statistically significant differences in the number of patients who required supplemental inotropes or vasopressors either during CPB, following separation from CPB, or upon arrival in the ICU. Thus, amrinone improved CI without changing pulmonary vascular resistance or the requirement for supplemental inotropes or vasopressors in patients undergoing elective mitral valve surgery.

Aged↗
PubMed2005

The effect of amrinone on liver regeneration in experimental hepatic resection model.

BACKGROUND: The phosphodiesterase inhibitors (PDEIs) have been proposed to improve hepatic reperfusion injury and hepatosplanchnic circulation, but the effects of these agents on liver regeneration have not been investigated thoroughly. The aim of this study was to investigate the effect of amrinone, a PDEI, on liver regeneration in rats. MATERIALS AND METHODS: Sixty rats were divided into two groups, control and amrinone. Each group was then divided into three groups (n=10). An infusion of amrinone to the study group and of 0.9% NaCl to the control group was performed. Seventy percent liver resection was performed to the rats during the first hour of infusion. The infusion was maintained for 17 h after resection. A total of 18 h infusion was performed. Rats were allowed to survive for 24, 48, and 72 h, and then they were sacrificed. Biochemical, morphological, hematological, and histopathologic measurements and assessments were performed. RESULTS: There were statistically significant differences between the amrinone and control groups in alkaline phosphatase and relative liver weights at 24, 48, and 72 h (P<0.05). There also were statistically significant differences between the groups in AST, bilirubin, and albumine levels at 24 h, ALT and prothrombine time levels at 48 h, and aspartate aminotransferase and alanine aminotransferase levels at 72 h (P<0.05). Hepatic ATP levels, mitotic index, and proliferating cell nuclear antigen labeling index were significantly higher in amrinone group compared with control group at all three time intervals (P<0.05). CONCLUSIONS: Amrinone improves both morphological and functional liver regeneration after liver resection.

Alanine Transaminase↗
PubMed1984

Failure of low doses of amrinone to produce sustained hemodynamic improvement in patients with severe chronic congestive heart failure.

Although amrinone produces acute hemodynamic improvement in patients with severe chronic congestive heart failure (CHF), it has not produced clinical benefits in long-term controlled trials. To determined if the administration of subtherapeutic doses of amrinone may account for its lack of efficacy in these studies, the dose requirements of the drug were investigated in 30 patients with severe CHF. Doses of 100 mg of oral amrinone produced moderate increases in cardiac index (0.35 liters/min/m2) and decreases in pulmonary capillary wedge pressure (6.8 mm Hg) and systemic vascular resistance (16%) (all p less than 0.01); these effects, however, were short-lived (less than 2.5 hours). Doses of 200 mg of oral amrinone produced marked increases in cardiac index (0.56 liters/min/m2) and substantial decreases in left ventricular filling pressure (9.9 mm Hg) and systemic vascular resistance (30%) (all p less than 0.01), and these effects persisted for longer than 4 hours. Only 4 patients showed hemodynamic responses with 100 mg of the drug that were sufficiently marked and long-lasting to merit chronic therapy, whereas 28 patients had such a response with the 200-mg dose. When 200 mg of amrinone was administered orally every 8 hours, sustained hemodynamic benefits were seen for 48 hours. However, 16 of 22 patients who received 600 mg of the drug daily for more than 1 week had intolerable adverse reactions that required drug withdrawal. In conclusion, hemodynamically effective doses of amrinone (600 mg/day) cannot be tolerated for long periods by most patients with severe chronic CHF.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Amrinone reduces ischaemia-reperfusion injury in rat heart.

We investigated the effects of amrinone on ischaemia-induced changes in myocardial function in isolated rat hearts. Isolated hearts from male Sprague-Dawley rats (150-275 g) were perfused with physiological salt solution at a constant flow rate. The effects of amrinone (30 microM) on left ventricular end diastolic pressure, positive and negative dP/dt, heart rate and coronary perfusion pressure were observed following global ischaemia and reperfusion. In normal hearts, amrinone had no effect on myocardial contractility, heart rate, coronary perfusion pressure or left ventricular end diastolic pressure. Ischaemia-reperfusion caused an increase in coronary perfusion pressure, left ventricular end diastolic pressure and creatine kinase outflow and amrinone (present from before ischaemia) decreased the rise in all of these parameters. However, when amrinone was added only after the ischaemia, it had no effect on coronary perfusion pressure or left ventricular end diastolic pressure. Thus, the effect on coronary perfusion pressure must be due to actions during the ischaemia phase. We suggest that amrinone has pharmacological properties which may be useful in reducing ischaemia-reperfusion injury. We speculate that this involves altering ischaemia-induced changes in intracellular Ca(2+) in the myocytes.

1-Methyl-3-isobutylxanthine↗
PubMed1984

Competitive inhibition of phosphodiesterase activity by amrinone: its implication in the cardiac effect of the drug.

The effects of amrinone on partially purified bovine heart PDE and on resting tension of isolated guinea-pig left atria were investigated. Amrinone strongly inhibited the high affinity Mg2+ dependent PDE activity present in the 105000xg supernatant fraction of heart homogenate (IC50 = 60 microM), but only weakly blocked the Ca2+-CaM-dependent PDE (IC50 = 2 mM). The inhibition of high affinity PDE was competitive in nature. In guinea-pig left atria driven at 1 Hz, amrinone induced a concentration-dependent positive inotropic effect (EC50 = 200 microM). This action was not followed by a rise of the diastolic tension, even when high amrinone concentrations (1 mM) and/or high external Ca2+ concentrations (up to 12.8 mM) were used. It is suggested that the competitive inhibition of PDE by amrinone can only partially account for its positive inotropic effect. Moreover, because of the lack of effect on diastolic tension, amrinone differs from methylxanthines and digitalis glycosides in regard to its influence on intracellular Ca2+ movements.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1991

[Hemodynamic effects of amrinone in low cardiac output after mitral valve replacement].

The efficacy of amrinone was assessed in the treatment of low cardiac output states occurring within 24 h after mitral valve replacement in an open prospective trial. It included 7 women and 5 men, aged 58 +/- 10 years. Four patients had also had simultaneous aortic valve replacement. Patients entered in the study if their cardiac index (CI) remained less than 2.2 l.min-1.m-2 after pulmonary wedged pressure (Ppw) had been increased to at least 15 mmHg, the patient having a temperature greater than 36 degrees C. Amrinone was given so as to increase Cl by at least 30% and to decrease Ppw by at least 30%. Patients were given a mean of 1.5 mg.kg-1 amrinone during the first hour, followed by a constant rate infusion of 9 +/- 3 micrograms.kg-1.min-1 over at least 24 h. The usual haemodynamic parameters were measured and calculated before giving amrinone, and after 1, 3, 6, 24, and 48 h. After 1 h of treatment, systolic arterial pressure, cardiac index, systolic index and left ventricular stroke work increased by 22, 42, 23, and 47% respectively, whilst Ppw decreased by 27% (p less than 0.01). Heart rate rose and systemic vascular resistance decreased but not significantly. Right atrial pressure, right ventricular stroke work, pulmonary artery pressure and pulmonary vascular resistance did not change. These effects were all maintained throughout the 48 h infusion. Amrinone had to be replaced by another agent (a beta-agonist) in 3 cases because of arrhythmia, lack of efficacy or thrombocytopaenia. In this setting, amrinone increased left ventricular performance with little effect on the right ventricle.

Adult↗
PubMed1986

Bipyridine cardiotonics: the three-dimensional structures of amrinone and milrinone.

The cardiotonic drug milrinone (1,6-dihydro-2-methyl-6-oxo-[3,4'-bipyridine]-5-carbonitrile) is superior to its analogue amrinone (5-amino-[3,4'-bipyridin]-6(1H)-one) by virtue of its greater potency and reduced side effect profile. We confirmed initial reports on the potencies of milrinone and amrinone and found that after intravenous administration to phenobarbital anesthetized dogs, the drugs had cumulative inotropic ED50's of 37 and 1891 micrograms/kg, respectively; relative effects on heart rate and blood pressure were comparable. There are two structural differences between amrinone and milrinone: (1) milrinone has a pyridone 2-methyl substituent and (2) the pyridone 5-amino substituent of amrinone is replaced with a nitrile in milrinone. We confirmed structure-activity studies that indicated that the 2-methyl substituent appears to be primarily responsible for the dramatic difference in the potencies of amrinone and milrinone. A plausible explanation for the effect of the methyl substituent is an altered molecular topology resulting from its steric interaction with the 3',5'-hydrogen atoms. Consequently, we probed the three-dimensional structures of these two compounds by X-ray crystallography. The dihedral angle between the planes formed by the two aromatic rings of amrinone was 1.3 degrees. In marked contrast, the corresponding angle for milrinone was 52.2 degrees. Moreover, 1H NMR studies revealed conformational differences in solution. Whereas the 2-methyl substituent undoubtedly produces some electronic and hydrophobic perturbations in the bipyridine cardiotonic series, the most significant effect, from a global viewpoint, is the altered molecular topology.

Aminopyridines↗
PubMed2000

Comparative effect of amrinone, aminophylline and diltiazem on rat airway smooth muscle.

We investigated the effect of amrinone, a phosphodiesterase III inhibitor, on rat airway smooth muscle, and thereafter, compared its activity with aminophylline and diltiazem. Amrinone produced relaxation of the acetylcholine-induced airway contraction in a dose-related manner. This bronchodilatory activity of amrinone was similar to that of aminophylline, but smaller than that of diltiazem. The 50% relaxant effect (ED50) of amrinone, aminophylline and diltiazem were 3.6 x 10(-4) M, 1.4 x 10(-4) M and 1.4 x 10(-5) M, respectively. Diltiazem was the most potent airway relaxant, and amrinone was less potent in these experiments. Taken together in its positive inotropic and chronotropic effects and anti-inflammatory activity, however, amrinone could be beneficial for treatment of patients suffering from asthma or heart failure with cardiac asthma.

Acetylcholine↗
PubMed2002

Cardiovascular effects of a phosphodiesterase III inhibitor, amrinone, in infants: non-invasive echocardiographic evaluation.

OBJECTIVE: The inotropic effect of amrinone is still controversial in management of congestive heart failure in pediatric patients, especially in infants. In order to determine the cardiovascular effect of amrinone in pediatric patients, we performed echocardiographic evaluation in 11 infants (mean age of 2 months) after intracardiac surgery. METHODS: Amrinone was loaded with a dose of 1.0 mg/kg, followed by continuous infusion with 10 microg/kg per min. We performed echocardiographic measurements before and immediately after loading of amrinone, and evaluated its cardiovascular effect. RESULTS: After loading of amrinone, the heart rate increased by 5% in average, but there was no change in blood pressure. Left ventricular (LV) fractional shortening and mean velocity of circumferential fiber shortening corrected for heart rate increased significantly (0.25 +/- 0.09 to 0.28 +/- 0.08 and 0.94 +/- 0.35 to 1.10 +/- 0.34, respectively). Left ventricular end-systolic wall stress decreased from 36.6 +/- 18.5 to 29.1 +/- 14.4 g/cm2, indicating the reduction of LV afterload. Stress-velocity index, a sensitive index of left ventricular contractility, was elevated significantly (Z-score: -1.45 +/- 4.21 to 0.04 +/- 4.11). CONCLUSION: Amrinone has not only vasodilative effects, but definite positive inotropic effects in infants with heart failure.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed2000

Influence of amrinone on intestinal villus blood flow during endotoxemia.

PURPOSE: The objective of this study was to determine the effects of a continuous infusion of the phosphodiesterase (PDE) inhibitor amrinone on mucosal villus blood flow in a normotensive model of endotoxemia. MATERIALS AND METHODS: Twenty-four anesthetized and ventilated rats underwent laparotomy, and an ileal portion was exteriorized and opened by an antimesenteric incision. The ileal segment was fixed on a plexiglass stage with the mucosal surface upward. Microcirculatory parameters were assessed by intravital videomicroscopy. The animals were randomly assigned to receive one of three treatments: infusion of Escherichia coli lipopolysaccharides (LPS, 2 mg/kg/h) without phosphodiesterase inhibitor pretreatment (LPS group); or infusion of LPS with amrinone pretreatment (40 microg/kg/min, start 30 minutes before LPS infusion) (amrinone group), or infusion of equivalent volumes of NaCl 0.9% (control group). Macrohemodynamic parameters (MAP, HR) and microhemodynamic parameters of ileal mucosa (mean diameter of central arterioles = D(A) and mean erythrocyte velocity within the arterioles = VE) were measured 30 minutes before and at 0, 60, and 120 minutes after induction of endotoxemia. Mucosal villus blood flow was calculated from D(A) and VE. RESULTS: In this normotensive endotoxemia model, MAP remained stable in the control and the LPS group but significantly decreased in the amrinone group.The endotoxin-induced decrease of V(E) and D(A) of central arterioles of mucosal villi could be attenuated and prevented, respectively. Thus, the endotoxin-induced decrease of mucosal villus blood flow was diminished but not fully restored by amrinone infusion. CONCLUSION: Our results indicate that amrinone during an early stage of sepsis is of limited value. It attenuates mucosal hypoperfusion but contributes to systemic hypotension.

Amrinone↗
PubMed1991

Quantitative assessment of the effects of 'inodilators' on the myocardium in patients without primary cardiac insufficiency after coronary surgery: Part I--Amrinone.

The positive inotropic and peripheral vasodilating effect of amrinone has been measured in 20 patients without manifest cardiac insufficiency during the early (8-18 h postoperative) and late (18-48 h postoperative) recovery phase after coronary surgery. On conclusion of the surgical intervention first the aortocoronary bypass flow was compared during dobutamine and amrinone administration. It increased by 88% with amrinone and by 19% with dobutamine. Then a needle force probe was implanted in the myocardium. Directly measured local myocardial force increased not significantly by 3.5% after the first and by 5.1% after the second bolus injection of 2 mg/kg amrinone. The rate of myocardial contraction increased by 18.7% and 12%. The rate of relaxation decreased by 5.3% after the first and increased by 15% after the second injection. Mean pulmonary arterial pressure fell from 18.5 to 15.5 mmHg and from 19.7 to 17 mmHg. Cardiac output increased by 23% after the first and by 20% after the second injection. Heart rate rose from 88 to 99 bpm and from 86 to 94 bpm. Total peripheral resistance fell from 1,035 to 706 dyn*s*cm-5 and from 1,036 to 819 dyn*s*cm-5. The systolic arterial pressure fell from 132 to 116 mmHg after the first injection and did not change after the second injection. Amrinone was found to be a powerful peripheral vasodilator with a mild positive inotropic action. The variations in the effects between the early and late recovery phases mainly reflect a progressive haemodynamic stabilization with a decreasing tendency toward hypotensive disregulation. Careful consideration has to be paid to a properly balanced filling of the vascular system before administering amrinone.

Adult↗
PubMed1987

Preliminary results with amrinone in perioperative low cardiac output syndrome.

The hemodynamic parameters of 24 cardiosurgical patients with low cardiac output syndrome (LCOS) after weaning from bypass were evaluated retrospectively. These patients were additionally treated with amrinone if the conventional therapy with catecholamines and vasodilators did not reach satisfying hemodynamic results. 14 patients underwent aorto-coronary bypass surgery, 10 patients underwent valve repair. Their disability by NYHA class was III and IV. One third of these patients died between the first and the fifth day postoperatively. Hemodynamic assessment was performed after weaning from bypass and after the start of amrinone therapy and was continued the first 24 hours in the intensive care unit, as long as the patients were dependent on amrinone. The platelet count was determined every eight hours after surgery. Under the supplementary therapy with amrinone we found an increase of the arterial pressure and cardiac index and decrease of heart rate and total peripheral resistance. These salutary hemodynamic changes could be sustained in the postoperative period. The platelet count dropped from nearly 100,000/mm3 in mean (first measurement post-op.) to 58,000 in mean (the lowest value during 48 hours on intensive care). 2 patients showed a decrease to 11,000 and 15,000/mm3 with petechial bleedings. These findings indicate that on the one hand amrinone seems to be a promising drug in cases of severe LCOS when conventional therapy fails, but on the other hand a marked decrease of the platelets can occur. Therefore a frequent control of platelet count has to be performed when using amrinone.

Aged↗
PubMed2002

The efficacy of preemptive Milrinone or Amrinone therapy in patients undergoing coronary artery bypass grafting.

UNLABELLED: Acute deterioration in ventricular function and oxygen transport is common after cardiac surgery. We hypothesized that milrinone or amrinone may reduce their occurrence and catecholamine requirements and increase cellular enzyme levels in patients undergoing coronary artery bypass. In 45 patients, we randomly administered milrinone 50 microg/kg plus 0.5 microg x kg(-1) x min(-1) infusion for 10 h, amrinone 1.5 mg/kg plus 10 microg x kg(-1) x min(-1) infusion for 10 h, or placebo at release of aortic cross-clamp. Hemodynamic variables, dopamine requirement, and laboratory values were recorded. At the postoperative nadir, stroke volume index was higher in the Milrinone and Amrinone groups (mean +/- SD, 27.8 +/- 4.0 and 26.1 +/- 3.2 vs. 20.4 +/- 5.1 mL x min (-1) x m(-2) per beat, P < 0.0001), and oxygen transport index was higher (354.7 +/- 57.8 and 353.7 +/- 91.2 vs 283.0 +/- 83.9 mL. min(-1) x m(-2), P = 0.009). The postoperative dopamine requirement was less (6.6 +/- 2.7 and 6.8 +/- 2.6 vs 10.4 +/- 2.0 mg/kg, P < 0.008), and postoperative serum lactate, alanine and aspartate aminotransferase, lactate dehydrogenase, creatinine kinase, C-reactive protein, and glucose levels were less (P < 0.01). The mean postoperative heart rate was faster in the Milrinone group than in the Amrinone and Placebo groups (96.8 +/- 10.3 vs. 86.9 +/- 9.5 and 87.8 +/- 10.8 bpm, P < 0.01). Milrinone and amrinone administered preemptively reduce postoperative deterioration in cardiac function and oxygen transport, dopamine requirement, and increases in serum lactate, glucose, and enzyme levels, although milrinone may increase heart rate. IMPLICATIONS: Preemptive milrinone or amrinone administration before separation from cardiopulmonary bypass in cardiac surgical patients not only ameliorates postoperative deterioration in cardiac function and oxygen transport, but also reduces dopamine requirement and increases serum lactate, glucose, and cellular enzyme levels, although milrinone may increase heart rate.

Aged↗