HEMODYNAMIC-EFFECT OF AMRINONE DEPENDS ON PRETREATMENT VASCULAR-RESISTANCE IN PATIENTS WITH EVOLVING CONGESTIVE-HEART-FAILURE - CORRELATIONBETWEEN VASCULAR-RESISTANCE AND NEUROHORMONAL ACTIVITY
T. Sasaki et al., HEMODYNAMIC-EFFECT OF AMRINONE DEPENDS ON PRETREATMENT VASCULAR-RESISTANCE IN PATIENTS WITH EVOLVING CONGESTIVE-HEART-FAILURE - CORRELATIONBETWEEN VASCULAR-RESISTANCE AND NEUROHORMONAL ACTIVITY, Journal of cardiovascular pharmacology, 31(1), 1998, pp. 80-84
We investigated the hemodynamic effects of amrinone and assessed its e
ffects on neurohormonal factors in 15 patients with evolving congestiv
e heart failure with various origins. We serially determined the pulmo
nary and systemic vascular-resistance indices after amrinone infusion
and examined the relation between changes in hemodynamic parameters an
d changes in concentrations of norepinephrine, atrial natriuretic pept
ide, angiotensin II, and endothelin-l in the pulmonary capillary wedge
region (PCWR) and in the peripheral veins. Amrinone significantly red
uced pulmonary vascular-resistance index (PVRI; Wood x m(2)) in patien
ts with high PVRI (greater than or equal to 15) before the infusion, s
ignificantly reduced systemic vascular-resistance index (SVRI; Wood x
m(2)) in patients with high SVRI (greater than or equal to 50) before
the infusion, and had little effect on vascular resistances in patient
s with low PVRI(<15) and low SVRI(<50). The reduction in PVRI was corr
elated with the reduction in the endothelin-l level (r=0.75) in the PC
WR, and the reduction in SVRI with norepinephrine level (r=0.70) in th
e peripheral veins, The angiotensin II level did not change throughout
the study. These findings suggest that amrinone had selective hemodyn
amic effects on pulmonary and systemic circulations with neurohormonal
effects, according to PVRI and SVRI before infusion.