Tanaka K, Takano T, Seino Y
Jpn Circ J. 1986 Jul;50(7):652-8. doi: 10.1253/jcj.50.652.
The hemodynamic effects of a newly developed inotropic agent, amrinone (AMN) were studied and compared with those of dopamine (DA) and dobutamine (DB) in forty patients with pump failure due to acute myocardial infarction. Hemodynamic measurements were taken using a Swan-Ganz thermodilution catheter before and 5, 10, 15, 30, 60, 90 and 120 minutes after intravenous injection of AMN (1-2 mg/kg) for 3 minutes in eight patients, and also before and during drip infusion (3-7 micrograms/kg/min) of DA in fifteen patients and DB in seventeen patients. AMN showed maximal increases in CI, SVI and SWI, and maximal lowering in CVP and SVR 5 minutes after intravenous injection, while maximal lowering in PCWP occurred 10 minutes after injection. These significant hemodynamic changes lasted for 60 minutes after injection. Comparing the maximal hemodynamic effects occurring 5 minutes after injection of AMN with those of DA and DB, it was found that AMN increased CI to almost the same degree as DA, and lowered CVP and PCWP much more compared to DB. These results suggest that AMN possesses a dominant vasodilating effect in addition to its inotropic effect, which would greatly benefit the treatment of refractory heart failure; AMN are the characteristic cardiovascular hemodynamic effects of as if catecholamine and a vasodilator were combined.
在40例急性心肌梗死所致泵衰竭患者中，研究了一种新开发的强心剂氨力农（AMN）的血流动力学效应，并与多巴胺（DA）和多巴酚丁胺（DB）进行了比较。在8例患者中，静脉注射氨力农（1-2mg/kg）3分钟，在注射前以及注射后5、10、15、30、60、90和120分钟，使用Swan-Ganz热稀释导管进行血流动力学测量；在15例患者静脉滴注多巴胺（3-7μg/kg/min）期间以及17例患者静脉滴注多巴酚丁胺期间，同样在滴注前及滴注过程中进行测量。静脉注射氨力农后5分钟，CI、SVI和SWI出现最大增幅，CVP和SVR出现最大降幅；而PCWP在注射后10分钟出现最大降幅。这些显著的血流动力学变化在注射后持续60分钟。将注射氨力农后5分钟出现的最大血流动力学效应与多巴胺和多巴酚丁胺的效应进行比较，发现氨力农使CI增加的程度与多巴胺几乎相同，与多巴酚丁胺相比，CVP和PCWP降低得更多。这些结果表明，氨力农除了具有正性肌力作用外，还具有显著的血管舒张作用，这将极大地有利于难治性心力衰竭的治疗；氨力农具有类似儿茶酚胺和血管舒张剂联合使用时的典型心血管血流动力学效应。
