Amrinone: Acute electrophysiologic and hemodynamic effects in patients with congestive heart failure

Naccarelli, Gerald V.; Gray, Elayne L.; Dougherty, Anne H.; Hanna, Joseph E.; Goldstein, Richard A.

doi:10.1016/0002-9149(84)90257-1

Cited by 38 publications

(2 citation statements)

References 15 publications

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“…On the contrary, HR remained unchanged with the administration of doses of amrinone resulting in increases in CO in a study by Naccarelli et al 30 In patients without cardiac disease, I]-agonists rarely cause important arrhythmias or myocardial ischaemia. However, patients with underlying coronary artery disease or preexisting arrhythmias are at much greater risk.…”

Section: Discussionmentioning

confidence: 91%

Amrinone, in combination with norepinephrine, is an effective first-line drug for difficult separation from cardiopulmonary bypass

et al. 1993

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Section: Discussionmentioning

confidence: 91%

Amrinone, in combination with norepinephrine, is an effective first-line drug for difficult separation from cardiopulmonary bypass

et al. 1993

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“…However, it had produced adverse reactions in which it increased the number and degree of ventricular arrhythmias. Previous studies also demonstrated that amrinone, a PDE3 inhibitor, decreased the effective refractory period of the right atrium and functional refractory period of the atrioventricular node [4,33,59,60]. In studies using milrinone, there was a trend toward a lower corrected sinusnode recovery time and maximal 1 : 1 atrioventricular conduction [33].…”

Section: Cilostazol and Bradyarrhythmiamentioning

confidence: 87%

Effects of cilostazol in the heart

Kanlop

Chattipakorn

2011

Journal of Cardiovascular Medicine

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Cilostazol is a selective phosphodiesterase 3 (PDE3) inhibitor approved by the Food and Drug Administration for treatment of intermittent claudication. It has also been used in bradyarrhythmic patients to increase heart rates. Recently, cilostazol has been shown to prevent ventricular fibrillation in patients with Brugada syndrome. Cilostazol is hypothesized to suppress transient outward potassium (Ito) current and increase inward calcium current, thus, maintaining the dome (phase 2) of action potential, decreasing transmural dispersion of repolarization and preventing ventricular fibrillation. Although many PDE3 inhibitors have been shown to increase cardiac arrhythmia in heart failure, cilostazol has presented effects that are different from other PDE3 inhibitors, especially adenosine uptake inhibition. Owing to this effect, cilostazol could be an effective cardioprotective drug, with its beneficial effects in preventing arrhythmia. In this review, the cardiac electrophysiological effects of cilostazol are presented and its possible cardioprotective effects, particularly in preventing ventricular fibrillation, are discussed, with emphasis on the need to further verify its clinical benefits.

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Evaluation of Intravenous Amrinone: The First of a New Class of Positive Inotropic Agents with Vasodilator Properties

1985

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Amrinone is the first noncatecholamine inotropic agent with substantial vasodilating properties to be approved by the Food and Drug Administration. Its use in acute congestive heart failure (CHF) is associated with significant increases in cardiac index, reductions in pulmonary capillary wedge pressure and systemic vascular resistance and little or no change in mean arterial pressure. Pharmacokinetic studies of amrinone report an elimination half-life of 2.6-8.3 hours, with slower elimination more likely in patients with compromised renal or hepatic function. Intravenous bolus doses of 0.75-3.5 mg/kg followed by infusions of 5-20 micrograms/kg/min produce hemodynamic improvements similar to those with dobutamine. Side effects with amrinone therapy are usually mild, but thrombocytopenia occurs in 2.4% of patients. Amrinone appears equally as efficacious as dobutamine in the management of acute CHF, but its role in therapy depends on efficacy and side effect data in greater numbers of patients.

show abstract

Amrinone: Acute electrophysiologic and hemodynamic effects in patients with congestive heart failure

Cited by 38 publications

References 15 publications

Amrinone, in combination with norepinephrine, is an effective first-line drug for difficult separation from cardiopulmonary bypass

Amrinone, in combination with norepinephrine, is an effective first-line drug for difficult separation from cardiopulmonary bypass

Effects of cilostazol in the heart

Evaluation of Intravenous Amrinone: The First of a New Class of Positive Inotropic Agents with Vasodilator Properties

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