Seino Y, Takano T, Hayakawa H, Kanmatsuse K, Saitoh S, Saitoh T, Kamishima G, Watanabe K, Motomiya T, Murata M
Nippon Medical School Hospital, Japan.
Cardiology. 1995;86(1):34-40. doi: 10.1159/000176828.
The present study evaluated the acute hemodynamic response, effects on subjective symptoms and physical findings, and the pharmacokinetics of a single oral dose (2.5, 5, or 10 mg) of milrinone in 31 patients with acute or decompensated heart failure. We found a significant increase in cardiac index (29, 31, and 29%, respectively, p < 0.01) and a significant decrease in pulmonary capillary wedge pressure (39, 43, and 47%, respectively, p < 0.01) accompanied with improvement in subjective symptoms and physical findings. These hemodynamic effects persisted for 4-8 h after each dosage of milrinone. Dose-dependent hemodynamic response was observed between the drug concentration and percent maximum changes in pulmonary capillary wedge pressure (peak milrinone concentration, 2.5 mg: 99.99 +/- 57.49, 5 mg: 187.11 +/- 71.37, and 10 mg: 300.94 +/- 158.5 ng/ml). The finding, together with results of the Prospective Randomized Milrinone Survival Evaluation (PROMISE) study, suggests lower dose of milrinone will be useful for the short-term inodilator support in patients with acute or decompensated heart failure.
本研究评估了31例急性或失代偿性心力衰竭患者单次口服米力农（2.5、5或10毫克）后的急性血流动力学反应、对主观症状和体格检查结果的影响以及药代动力学。我们发现心脏指数显著增加（分别为29%、31%和29%，p<0.01），肺毛细血管楔压显著降低（分别为39%、43%和47%，p<0.01），同时主观症状和体格检查结果有所改善。每次给予米力农后，这些血流动力学效应持续4至8小时。在药物浓度与肺毛细血管楔压最大变化百分比之间观察到剂量依赖性血流动力学反应（米力农峰值浓度，2.5毫克：99.99±57.49，5毫克：187.11±71.37，10毫克：300.94±158.5纳克/毫升）。这一发现与前瞻性随机米力农生存评估（PROMISE）研究的结果一起表明，较低剂量的米力农将有助于对急性或失代偿性心力衰竭患者进行短期的血管扩张剂支持治疗。
