| Comparison of Amrinone and Dopamine-Nitroglycerin on Hemodynamic Parameters in Dogs with Postinfarct Heart Failure. |
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Sok Ju Kim, Je Hwan Oh, Jung Won Park, Yong Hun Jung, Hyun Ju Oh, Su Won Oh, Young Cheol Woo, Jin Yun Kim, Gill Hoi Koo, Sun Gyoo Park |
1Department of Anesthesiology, College of Medicine, Chungang University, Seoul, Korea.
2Department of Anesthesiology, Gachon Medical College, Dongincheon Gil Hospital, Incheon, Korea. |
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| Abstract |
BACKGROUND
Left ventricular failure (LVF) after an acute myocardial infarction occurs during the perioperative period, and since this condition can lead to severe complications, intensive care is required for the patient.
LVF is characterized hemodynamically by a raised left heart filling pressure and volume and global depression of the hearts pumping performance. Several effective drugs for patients with heart failure are catecholamines such as dopamine and dobutamine, vasodilators such as nitroglycerin and nitroprusside, and noncatecholamine inotropes such as amrinone, which are either infused alone or in combination.
However, as of now, there has been no study as to clarifying either the exact dosage, drug combination, or how they affect the heart.
METHODS
By inducing a state of experimental acute left ventricular failure in 20 dogs through ligation of the left anterior descending coronary artery, this study compared the hemodynamic parameters of two treatment groups-one group using amrinone alone (bolus 1 mg/kg, continuous infusion 15micro gram/kg/min), and another group using a combination of dopamine (10micro gram/kg/min) and nitroglycerin (2micro gram/kg/min).
RESULTS
Cardiac output of dogs with postinfarct heart failure increased in both treatment groups. But, there was a significant decrease in systemic vascular resistance, pulmonary vascular resistance and left ventricular end diastolic pressure in the group treated with amrinone than dopamine-nitroglycerin. Amrinone also revealed a favorable effect on oxygen utility.
CONCLUSIONS
These results showed that amrinone might be more effective than the combination of dopamine and nitroglycerin for acute left ventricular failure in terms of myocardial function, hemodynamic stability and oxygen utility. |
| Key Words:
hemodynamics; ventricular function; amrinone; dopamine; nitroglycerin |
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