Clinical applications of amrinone.

A bipyridine derivative, amrinone is a noncatecholamine, nonglycoside alternative in the treatment of perioperative myocardial dysfunction. A type-3 phosphodiesterase enzyme inhibitor, amrinone combines positive inotropic support with systemic and pulmonary vasodilation. In patients with heart failure undergoing cardiac or noncardiac surgery, the absence of tachycardia and dysrhythmias is of particular clinical benefit. In these patients, amrinone's ability to augment cardiac performance without increasing heart rate or myocardial oxygen consumption offers significant clinical advantages during the perioperative period.