Klein N A, Siskind S J, Frishman W H, Sonnenblick E H, LeJemtel T H
Am J Cardiol. 1981 Jul;48(1):170-5. doi: 10.1016/0002-9149(81)90587-7.
Amrinone, a new inotropic agent, has been shown to be beneficial in patients with congestive heart failure. However, its hemodynamic effects have not been compared with those those of currently useful catecholamines. In this study, the effects of intravenously administered dobutamine and amrinone were compared in eight patients with severe chronic congestive heart failure. Dobutamine was infused with a maximal increase in cardiac index was reached for undesirable effects were produced. This dose was then continued for 8 hours. After a return of hemodynamic values to baseline level, amrinone was infused at a rate of 40 microgram/kg per min for 1 hour and then 10 microgram/kg per min for 24 hours. Both drugs significantly improved cardiac index while simultaneously decreasing systemic vascular resistance and right atrial and pulmonary wedge pressures (p less than 0.05). Initially no differences could be found between the drugs. However, with prolonged infusion amrinone produced a sustained improvement whereas dobutamine had a decreased effectiveness. Thus, amrinone is comparable in effect with the optimal dose of dobutamine and would appear to be an extremely promising drug in the acute treatment of severe congestive heart failure.
氨力农是一种新型的强心剂，已被证明对充血性心力衰竭患者有益。然而，其血流动力学效应尚未与目前常用的儿茶酚胺类药物进行比较。在本研究中，对8例严重慢性充血性心力衰竭患者静脉注射多巴酚丁胺和氨力农的效果进行了比较。多巴酚丁胺以最大剂量输注，直至达到心脏指数的最大增加量，同时出现不良反应。然后维持该剂量8小时。血流动力学值恢复到基线水平后，以40微克/千克每分钟的速率输注氨力农1小时，然后以10微克/千克每分钟的速率输注24小时。两种药物均显著改善心脏指数，同时降低全身血管阻力、右心房压力和肺楔压（p<0.05）。最初，两种药物之间未发现差异。然而，随着输注时间的延长，氨力农产生持续改善，而多巴酚丁胺的效果则下降。因此，氨力农在效果上与多巴酚丁胺的最佳剂量相当，似乎是急性治疗严重充血性心力衰竭的一种极有前景的药物。
