Amrinone versus conventional therapy in pulmonary hypertensive patients awaiting cardiac transplantation

Deeb, G. Michael; Boiling, Steven F.; Guynn, Todd; Nicklas, John M.

doi:10.1016/0003-4975(89)90785-6

Cited by 32 publications

(6 citation statements)

References 4 publications

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“…In adults and children, amr has been used safely without deleterious effects and has been effective in nonseptic pulmonary hypertensive states. [21][22][23] Amr reduces serum TxB, levels in vitro in human whole blood and in vivo in rabbits by inhibiting thromboxane synthase…”

Section: Discussionmentioning

confidence: 99%

Effect of amrinone during group B Strepfococcus‐induced pulmonary hypertension in piglets

Berger

Gibson

Clarke

et al. 1993

Pediatric Pulmonology

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Intravenous infusion of group B Streptococcus (GBS) into neonatal animals produces pulmonary hypertension, ventilation/perfusion (VA/Q) mismatch, and an increase in serum levels of thromboxane B2 (TxB2) and tumor necrosis factor (TNF) alpha. The vasodilator amrinone (amr) is a cGMP-inhibited phosphodiesterase inhibitor and is reported to inhibit thromboxane A2 and TNF production. We hypothesized that infusion of amr would cause pulmonary vasodilation and reduce serum TxB2 and TNF levels in piglets with late phase GBS-induced pulmonary hypertension. The effect of amr on gas exchange was also determined. A continuous infusion of GBS was administered for 5 hr to 4 groups of anesthetized, mechanically ventilated neonatal piglets. An amr bolus of 8 mg/kg was given at 4 hr followed by a 1 hr continuous infusion of either 10 or 20 micrograms/kg/min of amr (amr 10 and amr 20, respectively). Control piglets received a bolus and 1 hr infusion of amr carrier. The infusion of amr, but not of carrier reversed late phase GBS-induced pulmonary hypertension. Piglets infused with amr 20 showed transient selective pulmonary vasodilation, based on a reduced ratio of pulmonary to systemic vascular resistance (PVR/SVR ratio) value at 30 min but not at 1 hr, compared to pre-amr treatment values. The PVR/SVR ratio values for amr 10 and control group did not change after treatment with either amr or carrier. Treatment with amr 10 or 20 did not decrease serum TxB2 or TNF levels or increase VA/Q mismatch.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 99%

Effect of amrinone during group B Strepfococcus‐induced pulmonary hypertension in piglets

Berger

Gibson

Clarke

et al. 1993

Pediatric Pulmonology

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“…Because of these disadvantages, a medication such as amrinone may have potential for long-term PDGF-like protein inhibition. Oral amrinone has been used clinically in trials to treat chronic congestive heart failure as well as pulmonary hypertension in heart transplant patients awaiting transplantation (28)(29)(30). Clinical utility in infants may be limited by the apparent differential effects of amrinone on newborn and adult myocardium (3 1, 32).…”

Section: Discussionmentioning

confidence: 99%

Effects of Amrinone on Thrombin-Induced Platelet-Derived Growth Factor-Like Protein Secretion from Endothelial Cells

1991

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“…15,20 A true reduction of PVR is therefore questionable according to the opening pressure concept of the pulmonary vasculature in heart failure. 26 Accordingly, these inotropic agents are not useful for testing of reversibility.…”

Section: Drugs For Reversibility Testingmentioning

confidence: 99%

“…8,13 Inotropic agents, such as dobutamine or enoximone, and vasodilating agents, such as nitroglycerin, nitroprusside, adenosine, sitaxsentan (an endothelin receptor blocker), prostglandin I 2 , prostaglandin E 1 and inhaled nitric oxide, have been evaluated in studies with small numbers of patients. 11,[15][16][17][18][19][20][21][22][23][24] At present, there is no clear consensus on the best agent available, but nitric oxide and prostaglandin E 1 appear to be the most promising. 18,20,24 Because there is a lack of a guideline-recommended, standardized protocol for pre-transplant reversibility testing of elevated PVR, and a lack of any prospective study evaluating the effectiveness of a potent vasodilator for reversibility of PVR in a large group of heart transplant candidates, the Working Group on Thoracic Organ Transplantation of the German Society of Cardiology designed and performed the PROPHET study.…”

mentioning

confidence: 99%

Prostaglandin E1 Testing in Heart Failure–associated Pulmonary Hypertension Enables Transplantation: The PROPHET Study

Scheidt

Costard-Jaeckle

Stempfle³

et al. 2006

The Journal of Heart and Lung Transplantation

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Amrinone versus conventional therapy in pulmonary hypertensive patients awaiting cardiac transplantation

Cited by 32 publications

References 4 publications

Effect of amrinone during group B Strepfococcus‐induced pulmonary hypertension in piglets

Effect of amrinone during group B Strepfococcus‐induced pulmonary hypertension in piglets

Effects of Amrinone on Thrombin-Induced Platelet-Derived Growth Factor-Like Protein Secretion from Endothelial Cells

Prostaglandin E1 Testing in Heart Failure–associated Pulmonary Hypertension Enables Transplantation: The PROPHET Study

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