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European Heart Journal 1986 7(7):621-627;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

Variability of positive inotropic response to acute amrinone administration in chronic cardiac failure

R. SCOGNAMIGLIO*,, G. FASOLI*, L. VLSINTIN*, I. MARAGNO*, G. CARGNELLL{dagger}, D. PIOVAN{dagger} and S. DALLA-VOLTA*

*Department of Cardiology, University of Padua Padua, Italy
{dagger}Department of Clinical Pharmacology, University of Padua Padua, Italy

Received 17 September 1985; revised 5 January 1986; .

R.Scognamiglio, Cattedra di Cardioiogia, Policlinico. via Giustiniam 2,35100 Padova, Italy

Abstract

To determine the factors conditioning the variability of positive inotropic response after intravenous acute amrinone administration, 14 patients with chronic cardiac failure were studied by quantitative M-mode and cross-sectional echocardiography. Six patients had idiopathic dilated cardiomyopathy and 8 patients had severe chronic aortic insufficiency. Myocardial contractility (evaluated as peak arterial systolic pressure/end-systolic volume ratio: PAP/ESV) did not change in patients with idiopathic cardiomyopathy, a significant increase of mycocardial contractility occurred in patients with aortic regurgitation only if the control value of PAP/ESV was greater than 1. Mean systolic wall stress decreased significantly in all patients, independent of aetiology of cardiac failure and was the factor determining the improvement of left ventricular performance (evaluated as fractional shortening) in patients without changes in myocardial contractility. Maximum improvement in left ventricular performance occurred 10 minutes after amrinone administration. It is concluded that the possibility of detecting the positive inotropic properties of amrinone in man depends on the aetiology of the cardiac failure and on the basal level oxf myocardial contractility.

Key Words: Quantitative echocardiography, • myocardial contractility, • cardiovascular pharmacology.


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