Sonnenblick E H, Grose R, Strain J, Zelcer A A, LeJemtel T H
Circulation. 1986 Mar;73(3 Pt 2):III162-7.
The potent vasodilating properties of the bipyridine derivatives confounds the assessment of changes in contractility as measured by peak positive left ventricular dP/dt and explains why the positive inotropic action of these agents has not been consistently demonstrated in patients with ventricular dysfunction. Therefore we studied the individual dose-response effects of intravenous milrinone on myocardial contractility as measured by peak positive left ventricular dP/dt in the context of concurrent changes in ventricular filling pressure. Incremental doses of milrinone caused a dose-related increase in peak positive left ventricular dP/dt in six of 11 patients. Peak positive left ventricular dP/dt was unchanged in four patients and reduced in one patient, all of whom experienced a substantial fall in left ventricular filling pressure. Thus milrinone has a definite inotropic effect in addition to its potent vasodilating properties.
联吡啶衍生物强大的血管舒张特性干扰了通过左心室dp/dt峰值来评估收缩性变化，这也解释了为何在心室功能不全患者中这些药物的正性肌力作用未能得到一致证实。因此，我们在心室充盈压同时发生变化的情况下，研究了静脉注射米力农对通过左心室dp/dt峰值测量的心肌收缩性的个体剂量反应效应。在11例患者中，有6例随着米力农剂量递增，左心室dp/dt峰值呈剂量相关增加。4例患者的左心室dp/dt峰值未变，1例患者的该峰值降低，所有这些患者的左心室充盈压均大幅下降。因此，米力农除具有强大的血管舒张特性外，还具有明确的正性肌力作用。
