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Query: UMLS:C0038454 (
stroke
)
147,016
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The hemodinamic effects of
Amrinone
, bipiridine derivate with positive inotropic effects in animals, were studied on eight patients under right and left heart catheterization. The cardiac index,
stroke
volume, dP/dt and
stroke
work index were increased; the pulmonary pressure and the left ventricle end diastolic pressure were decreased all with statistical significant values. There were no changes in mean aortic pressure. These effects are mainly due to an increase in contractility and, partially, to vasodilation and tachycardia. The intrinsic mechanism of action of this compound is not known. Its place in cardiac therapy must be established with additional clinical investigations.
...
PMID:[Hemodynamic effects of various doses of a new inotropic: amrinoma]. 12 81
Amrinone
was given intravenously combined with the routine treatment to 10 patients with late chronic cor pulmonale in exacerbation stage. The initial loading dose was 1.5-2 mg/kg followed by the maintenance dose of 15 micrograms/kg. min for 6 hours. Hemodynamic and blood gas monitoring showed that pulmonary artery pressure, pulmonary vascular resistance index, right atrial pressure and pulmonary capillary wedge pressure decreased significantly and maintained the level markedly below baseline after amrinone administration (the extents decreased were 0.53-1.1 kPa, 80-140 dyn.s.m2.cm-5, 0.27-0.40 kPa and 0.40-0.67 kPa respectively. P < 0.05 for each parameter) and that cardiac index and
stroke
volume index increased identically (the extents increased were 0.3-0.6 L/min.m2 and 2-4 ml/beat.m2 respectively, P < 0.05 for each parameter). There were no significant changes in systemic artery pressure, arterial blood gas analysis and blood platelet count after amrinone administration. We suggest that amrinone may be effective in the treatment of cardio-pulmonary decompensated chronic cor pulmonale.
...
PMID:[Hemodynamic effects of amrinone on cardiopulmonary decompensated chronic cor pulmonale]. 133 21
To evaluate the interaction of amrinone with inhalational anesthetics, cardiovascular effects of amrinone were investigated in nine mongrel dogs anesthetized with enflurane. Each dog received enflurane and amrinone in the following sequence: 1) 2% enflurane alone, 2) continuous infusion of 20 micrograms.kg-1.min-1 during enflurane, 3) 40 micrograms.kg-1.min-1 infusion during enflurane.
Amrinone
40 micrograms.kg-1.min-1 during enflurane anesthesia improved the maximum left ventricular dP/dt,
stroke
volume and decreased effective arterial elastance (Ea) without changes in left ventricular end-diastolic pressure and heart rate. Left ventricular pressure (LVP) and systolic femoral arterial pressure were stable, but diastolic femoral arterial pressure decreased significantly from enflurane anesthesia alone. These parameters at 20 micrograms.kg-1.min-1 of amrinone infusion during enflurane showed the same tendency with 40 micrograms.kg-1.min-1 infusion but not significantly different from enflurane alone. This result suggests that amrinone may be beneficial in the patients with depression of cardiac performance during anesthesia.
...
PMID:[Amrinone reverses cardiac depression by enflurane in the dog]. 147 64
This study's objective is to evaluate the ability of glucagon and amrinone to reverse propranolol induced cardiovascular depression in a canine model, compared to a control of normal saline. The study design included 18 animals which received intravenous propranolol (10 mg/kg) resulting in significant depression in heart rate, cardiac output, mean arterial pressure, maximal ventricular dP/dt and
stroke
volume. Each canine was randomly assigned to one of three treatment groups; controls (normal saline only), glucagon (20 micrograms/kg bolus) and amrinone (4 mg/kg bolus). Cardiovascular parameters were monitored at 1, 6, 11, 21 and 31 min after treatment was rendered. Multiple comparison procedures at each time period controlled the overall alpha-level at .05. Compared to control animals, both amrinone and glucagon were effective in reversing propranolol-induced depression of dP/dtmax at 6 and 11 min for glucagon and 11 min for amrinone and cardiac output at 1, 6 and 11 min for glucagon and 1 min for amrinone.
Amrinone
and glucagon significantly increased
stroke
volume over control values at 1 min and tended to do so at the remaining time periods. The two days caused a similar degree of arteriolar vasodilation which was significantly greater than that seen in control animals at 1 and 6 min. Beta blocker induced bradycardia did not respond significantly to amrinone while glucagon induced a tachycardia which is unique to canines. It is concluded that in this canine model, amrinone appears to be an effective therapeutic alternative to glucagon for reversing depressed dP/dtmax, cardiac output and stoke volume induced by propranolol toxicity. Unlike glucagon, amrinone appears to lack positive chronotropic activity which may limit its clinical utility in the treatment of beta blocker overdose.
...
PMID:A comparison of amrinone and glucagon therapy for cardiovascular depression associated with propranolol toxicity in a canine model. 151 13
To contrast the effect of increasing blood calcium concentrations on the cardiovascular actions of intravenous beta-adrenergic agonists and phosphodiesterase inhibitors, 46 patients recovering from aortocoronary bypass surgery received either dobutamine or amrinone both in the presence and absence of a calcium infusion. Cardiac output, systemic arterial pressure, pulmonary arterial pressure, central venous pressure, pulmonary artery occlusion pressure, heart rate, and blood ionized calcium concentration were measured before and during infusions of dobutamine (2.5 and 5.0 micrograms/kg/min) and amrinone (0.75 mg/kg bolus + 10 micrograms/kg/min or 2.25 mg/kg bolus + 20 micrograms/kg/min). After the initial dobutamine infusion period, patients were randomly and blindly assigned to receive either a calcium or placebo infusion, and the dobutamine infusions were repeated. Because of the long duration of amrinone's actions, the amrinone maintenance infusion was continued while randomized, blinded infusion of either calcium or placebo was added. Dobutamine (5 micrograms/kg/min) increased cardiac output from 7.1 +/- 0.3 L/min to 9.1 +/- 0.4 L/min, and increased heart rate from 93 +/- 4 beats/min to 107 +/- 4 beats/min. Systemic vascular resistance decreased and
stroke
volume increased. Dobutamine had no significant effects on other hemodynamic values.
Amrinone
(2.25 mg/kg bolus + 20 micrograms/kg/min) increased cardiac output from 5.6 +/- 0.4 L/min to 6.9 +/- 0.5 L/min, and increased heart rate from 87 +/- 3 beats/min to 98 +/- 3 beats/min.
Amrinone
decreased mean arterial pressure, systemic vascular resistance, pulmonary artery occlusion pressure, central venous pressure, and pulmonary artery pressure. Calcium infusion increased arterial pressure (8 to 13 percent) but had no significant effects on any other hemodynamic parameters. Calcium reduced the increase in cardiac output produced by dobutamine by 30 percent, but it did not alter the cardiotonic actions of amrinone. Thus, calcium inhibits the cardiotonic actions of certain beta-adrenergic agonists, most likely by interfering with signal transduction through the beta-adrenergic receptor complex.
...
PMID:Calcium inhibits the cardiac stimulating properties of dobutamine but not of amrinone. 172 65
Hemodynamic measurements were done in 42 patients with congestive heart failure of NYHA classes III and IV after administration of the phosphodiesterase inhibitors amrinone und enoximone.
Amrinone
decreases mean arterial pressure (-4%), right atrial pressure (-39%), and systemic vascular resistance (-23%), while cardiac index and
stroke
volume index increase to 27% and 26%, respectively; heart rate is nearly unchanged. Enoximone administration in a dose of 1 mg/kg bw produces an increase in cardiac index of 13%, an increase in heart rate of 12%, and a decrease of systemic vascular resistance of 13%, whereas
stroke
volume index is unchanged. Enoximone in a dose of 1.5 mg/kg bw increases heart rate (+ 9%), cardiac index (+ 33%), and
stroke
volume index (+ 21%), and decreases systemic vascular resistance (-26%). The hemodynamic profile of amrinone and enoximone in an equal dose shows only slight differences. Furthermore, phosphodiesterase inhibitors produce an increase of cardiac index (+ 19%) and
stroke
volume index (+ 17%) in patients with pump failure having already received dopamine and dobutamine.
...
PMID:[The hemodynamic profile of amrinone and enoximone in patients with severe heart failure]. 183
Seven Yucatan minipigs with chronic, severe intraperitoneal sepsis were given amrinone i.v. (loading dose of 0.75 mg/kg, followed by continuous infusion of 10, 20, 40, and 80 micrograms/kg/min) during the hyperdynamic phase of sepsis. Hemodynamic variables and oxygen utilization, delivery, and extraction were recorded throughout the study. Pulmonary capillary wedge pressure was kept constant to ensure a fixed ventricular filling pressure. Intravenous amrinone modestly augmented cardiac index without altering heart rate. Mean systemic and pulmonary arterial pressures decreased. Systemic and pulmonary vascular resistance fell significantly (P less than 0.05).
Amrinone
did not significantly alter oxygen utilization or oxygen extraction, although oxygen delivery increased (P less than .05). During the hyperdynamic phase of sepsis in this animal model, amrinone elicits vasodilatation with a modest improvement in
stroke
volume index. Consequently, cardiac output and oxygen delivery increased modestly. Because of its vasodilating properties and small salutary effects, amrinone is not an optimal first-line medication for hemodynamic stabilization during hyperdynamic sepsis.
...
PMID:Amrinone during porcine intraperitoneal sepsis. 193 25
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.
...
PMID:[Hemodynamic effects of amrinone in low cardiac output after mitral valve replacement]. 205 29
A prospective randomized study was performed in 46 consecutive patients with refractory congestive heart failure (CHF) due to idiopathic dilated cardiomyopathy to compare the hemodynamic responses to 48-hour infusions of amrinone and dobutamine. Both drugs substantially reduced pulmonary arterial wedge pressure, right atrial pressure and systemic vascular resistance and increased cardiac index.
Amrinone
caused a greater decrease in right atrial pressure than dobutamine (p less than 0.02) and had a positive chronotropic effect not observed with dobutamine (p less than 0.01). The increase in heart rate produced by amrinone correlated inversely with the changes in right atrial and pulmonary arterial wedge pressures, suggesting a baroreceptor response to reduced preload. Dobutamine produced a larger increase in
stroke
volume index than amrinone (p less than 0.01). Ninety-one percent of patients receiving amrinone and only 65% receiving dobutamine had reduction of greater than or equal to 30% in pulmonary arterial wedge pressure (p less than 0.05). Cardiac index increased greater than or equal to 30% in similar numbers of patients given amrinone (74%) and dobutamine (65%). Negative fluid balance was recorded in all patients receiving amrinone and in 78% of patients receiving dobutamine (p less than 0.05). Target hemodynamic criteria were achieved in 83% of patients receiving 10 micrograms/kg/min of amrinone. The effective maintenance dose of dobutamine was extremely variable. No clinically important adverse effects were observed with either drug regimen. Both amrinone and dobutamine are effective and safe agents for short-term parenteral therapy of patients with dilated cardiomyopathy in severe CHF that is unresponsive to oral medication.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Comparison of intravenous amrinone and dobutamine in congestive heart failure due to idiopathic dilated cardiomyopathy. 222 Jun 38
The hemodynamic effects of amrinone were assessed in seven children following cardiac surgery.
Amrinone
was administered as a bolus of 1 mg kg-1 body wt., followed by continuous infusion at 10 micrograms kg-1 min-1 for 1 h and two stepwise increases to 20 and 40 micrograms kg-1 min-1 for 30 min each. Hemodynamic data were obtained and plasma concentrations of amrinone measured 1 h after the bolus dose and immediately before each increment of the infusion rate.
Amrinone
levels ranged from 0.7 to 2.3 mg l-1. Administration of amrinone lowered systemic vascular resistance from 20.0 +/- 4.3 to 16.5 +/- 4.6 mmHg l-1 min-1 m-2 (p less than 0.05) and reduced mean arterial pressure from 71.7 +/- 9.5 to 62.6 +/- 13.5 mmHg (p less than 0.05) at the highest infusion rate, confirming the known vasodilative effect of the drug. However, these effects did not result in a statistically significant increase in
stroke
volume (35.0 +/- 7.5 to 35.5 +/- 7.0 ml m-2, NS) or cardiac index (3.10 +/- 0.50 to 3.20 +/- 0.40 l min-1 m-2). One additional patient, in whom a higher loading dose was tried in order to achieve a higher plasma concentration, developed systemic hypotension. A correlation was established between the plasma concentrations of amrinone and the percentage decrease in systemic resistance (r = 0.70, p less than 0.05). These results suggest that in children after open heart surgery, amrinone acts primarily as a systemic vasodilator, with questionable inotropic effect. Accordingly, its use should be restricted to children with severe cardiac failure and documented highly elevated afterload.
...
PMID:Hemodynamic effects of amrinone in children after cardiac surgery. 233 44
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