Naccarelli G V, Gray E L, Dougherty A H, Hanna J E, Goldstein R A
Am J Cardiol. 1984 Sep 1;54(6):600-4. doi: 10.1016/0002-9149(84)90257-1.
Amrinone is an effective inotropic agent, but its electrophysiologic effects in humans have not been previously determined. Fifteen patients with congestive heart failure (CHF) New York Heart Association functional class II to IV, underwent an electrophysiologic study after withdrawal of all other cardioactive drugs before and after 10 to 20 micrograms/kg/min of intravenous amrinone (doses that increased cardiac index and decreased pulmonary capillary wedge pressure and systemic vascular resistance, p less than 0.002). Amrinone caused no change in PR, QRS, QTc, AH or HV intervals or maximal corrected sinus node recovery time and had no significant effect on the ventricular effective refractory periods. Amrinone decreased the atrial effective refractory period from 256 +/- 40 to 240 +/- 38 ms (p = 0.015), and the atrioventricular (AV) nodal functional refractory period from 374 +/- 65 to 356 +/- 64 ms (p less than 0.05), and enhanced maximal 1:1 AV nodal conduction from 371 +/- 46 to 334 +/- 47 ms (p = 0.006). Nine patients had baseline HV prolongation; this was not affected by amrinone. The frequency of inducible ventricular tachycardia was not significantly affected by amrinone. Holter recordings (24 to 48 hours) were obtained from 10 patients before and after acute oral amrinone dosing (75 to 150 mg every 8 hours). There was no change in the number of ventricular premature contractions per 24 hours (2,197 +/- 3,305 vs 2,616 +/- 2,436) or number of runs of ventricular tachycardia per 24 hours (10 +/- 12 vs 12 +/- 13); however, the number of ventricular couplets per 24 hours increased from 22 +/- 34 to 52 +/- 55 (p = 0.054).(ABSTRACT TRUNCATED AT 250 WORDS)
氨力农是一种有效的强心剂，但其对人体的电生理作用此前尚未确定。15例纽约心脏协会心功能II至IV级的充血性心力衰竭（CHF）患者，在停用所有其他心脏活性药物后，接受了电生理研究，分别在静脉注射氨力农10至20微克/千克/分钟之前和之后进行（这些剂量可增加心脏指数、降低肺毛细血管楔压和全身血管阻力，p<0.002）。氨力农对PR、QRS、QTc、AH或HV间期或最大校正窦房结恢复时间无影响，对心室有效不应期也无显著影响。氨力农使心房有效不应期从256±40毫秒降至240±38毫秒（p=0.015），房室（AV）结功能不应期从374±65毫秒降至356±64毫秒（p<0.05），并使最大1:1房室结传导从371±46毫秒增强至334±47毫秒（p=0.006）。9例患者基线HV延长，这不受氨力农影响。可诱发室性心动过速的频率未受氨力农显著影响。对10例患者在急性口服氨力农给药（每8小时75至150毫克）之前和之后进行了24至48小时的动态心电图记录。每24小时室性早搏数量（2197±3305对2616±2436）或每24小时室性心动过速发作次数（10±12对12±13）无变化；然而，每24小时室性成对早搏数量从22±34增加至52±55（p=0.054）。（摘要截短于250字）
