Cardiovascular effects of a phosphodiesterase III inhibitor, amrinone, in infants: Non-invasive echocardiographic evaluation

Objective : The inotropic effect of amrinone is still controversial in management of congestive heart failure in pediatric patients, especially in infants. In order to determine the cardiovascular effect of amrinone in pediatric patients, we performed echocardiographic evaluation in 11 infants (mean...

Full description

Saved in:
Bibliographic Details
Published in:Pediatrics international 2002-06, Vol.44 (3), p.259-263
Main Authors: Teshima, Hidetaka, Tobita, Kimimasa, Yamamura, Hideshi, Takeda, Atsuhito, Motomura, Hideki, Nakazawa, Makoto
Format: Article
Language:English
Subjects:
3',5'-Cyclic-AMP Phosphodiesterases - antagonists & inhibitors
amrinone
Amrinone - pharmacology
Cardiac Surgical Procedures
Cardiotonic Agents - pharmacology
Cyclic Nucleotide Phosphodiesterases, Type 3
Echocardiography
Female
Heart - drug effects
Heart Defects, Congenital - physiopathology
Heart Defects, Congenital - surgery
heart failure
Hemodynamics - drug effects
Humans
Infant
Infant, Newborn
infants
Male
Phosphodiesterase Inhibitors - pharmacology
Vasodilator Agents - pharmacology
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective : The inotropic effect of amrinone is still controversial in management of congestive heart failure in pediatric patients, especially in infants. In order to determine the cardiovascular effect of amrinone in pediatric patients, we performed echocardiographic evaluation in 11 infants (mean age of 2 months) after intracardiac surgery. Methods : Amrinone was loaded with a dose of 1.0 mg/kg, followed by continuous infusion with 10 µg/kg per min. We performed echocardiographic measurements before and immediately after loading of amrinone, and evaluated its cardiovascular effect. Results : After loading of amrinone, the heart rate increased by 5% in average, but there was no change in blood pressure. Left ventricular (LV) fractional shortening and mean velocity of circumferential fiber shortening corrected for heart rate increased significantly (0.25 ± 0.09 to 0.28 ± 0.08 and 0.94 ± 0.35 to 1.10 ± 0.34, respectively). Left ventricular end‐systolic wall stress decreased from 36.6 ± 18.5 to 29.1 ± 14.4 g/cm2, indicating the reduction of LV afterload. Stress‐velocity index, a sensitive index of left ventricular contractility, was elevated significantly (Z‐score: −1.45 ± 4.21 to 0.04 ± 4.11). Conclusion : Amrinone has not only vasodilative effects, but definite positive inotropic effects in infants with heart failure.
ISSN:1328-8067
1442-200X
DOI:10.1046/j.1442-200X.2002.01552.x