Scognamiglio R, Fasoli G, Visintin L, Maragno I, Cargnelli G, Piovan D, Dalla-Volta S
Eur Heart J. 1986 Jul;7(7):621-7. doi: 10.1093/oxfordjournals.eurheartj.a062113.
To determine the factors conditioning the variability of positive inotropic response after intravenous acute amrinone administration, 14 patients with chronic cardiac failure were studied by quantitative M-mode and cross-sectional echocardiography. Six patients had idiopathic dilated cardiomyopathy and 8 patients had severe chronic aortic insufficiency. Myocardial contractility (evaluated as peak arterial systolic pressure/end-systolic volume ratio: PAP/ESV) did not change in patients with idiopathic cardiomyopathy, a significant increase of myocardial contractility occurred in patients with aortic regurgitation only if the control value of PAP/ESV was greater than 1. Mean systolic wall stress decreased significantly in all patients, independent of aetiology of cardiac failure and was the factor determining the improvement of left ventricular performance (evaluated as fractional shortening) in patients without changes in myocardial contractility. Maximum improvement in left ventricular performance occurred 10 minutes after amrinone administration. It is concluded that the possibility of detecting the positive inotropic properties of amrinone in man depends on the aetiology of the cardiac failure and on the basal level of myocardial contractility.
为了确定静脉内急性给予氨力农后正性肌力反应变异性的影响因素，我们采用定量M型和二维超声心动图对14例慢性心力衰竭患者进行了研究。其中6例为特发性扩张型心肌病患者，8例为重度慢性主动脉瓣关闭不全患者。特发性心肌病患者的心肌收缩力（以动脉收缩压峰值/收缩末期容积比：PAP/ESV评估）未发生变化，仅当PAP/ESV的对照值大于1时，主动脉瓣反流患者的心肌收缩力才会显著增加。所有患者的平均收缩期壁应力均显著降低，与心力衰竭的病因无关，并且是在心肌收缩力无变化的患者中决定左心室功能改善（以缩短分数评估）的因素。氨力农给药后10分钟左心室功能出现最大改善。得出的结论是，在人体中检测氨力农正性肌力特性的可能性取决于心力衰竭的病因和心肌收缩力的基础水平。
