Ichioka S, Nakatsuka T, Sato Y, Shibata M, Kamiya A, Harii K
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tokyo, Japan.
J Surg Res. 1998 Feb 15;75(1):42-8. doi: 10.1006/jsre.1998.5266.
Amrinone, a selective phosphodiesterase (PDE) III inhibitor, is a newly developed agent that possesses a combination of positive inotropic and vasodilating properties as a result of preventing the degradation of cAMP and it has recently been licensed for treatment of heart failure alone. Amrinone is expected to be useful for the treatment not only of heart failure but also of peripheral circulatory disorders, including vascular disease, and for ischemic flaps, because it improves microcirculatory hemodynamics. To investigate potential therapeutic applications of amrinone, we evaluated its ability to improve microcirculatory hemodynamics and flap survival.
The rat skinfold chamber technique was employed to quantify microcirculation directly in vivo. The improved survival area of random flaps in rats treated with amrinone was examined to assess therapeutic efficacy of this drug. Its effects were compared with those of prostaglandin E1 (PGE1), which has been widely approved as an agent for improving hemodynamics.
Microcirculatory blood flow and flap survival area were significantly increased in both amrinone- and PGE1-treated animals, compared to the saline-treated controls. The ameliorating effects of amrinone were comparable to those of PGE1.
The results of this study suggest amrinone to be a potentially useful drug not only for treating heart failure but also for improving microcirculation in patients with vascular diseases and for postoperative care after reconstructive surgery.
氨力农是一种选择性磷酸二酯酶(PDE)III抑制剂,是一种新开发的药物,由于可防止环磷酸腺苷(cAMP)降解,因而兼具正性肌力和血管舒张特性,最近已被批准单独用于治疗心力衰竭。氨力农有望不仅用于治疗心力衰竭,还可用于治疗包括血管疾病在内的外周循环障碍以及缺血皮瓣,因为它可改善微循环血流动力学。为了研究氨力农的潜在治疗应用,我们评估了其改善微循环血流动力学和皮瓣存活的能力。
采用大鼠皮褶箱技术直接在体内定量微循环。检查用氨力农治疗的大鼠随意皮瓣的存活面积改善情况,以评估该药物的治疗效果。将其效果与已被广泛认可为改善血流动力学药物的前列腺素E1(PGE1)的效果进行比较。
与生理盐水处理的对照组相比,氨力农和PGE1处理的动物的微循环血流量和皮瓣存活面积均显著增加。氨力农的改善效果与PGE1相当。
本研究结果表明,氨力农不仅是治疗心力衰竭的潜在有用药物,而且对于改善血管疾病患者的微循环以及重建手术后的术后护理也有潜在作用。