Abstract | OBJECTIVES: BACKGROUND: Previous studies have suggested that the inotropic response to dobutamine can identify viable myocardium in the setting of chronic coronary disease and left ventricular dysfunction. However, increased oxygen demand stimulated by dobutamine can lead to superimposition of ischemia on the hibernating state, potentially confounding interpretation of results. Amrinone is an inotropic agent that does not critically augment myocardial oxygen demand and may be useful for identification of hibernating myocardium in the chronically ischemic state. METHODS: RESULTS: Baseline ejection fraction was 28 +/- 7% (mean +/- SD). Ejection fraction increased to 35 +/- 5% after amrinone stimulation (p < 0.0001) and to 33 +/- 6% after bypass surgery (p < 0.0001). Postbypass ejection fraction was significantly correlated with postamrinone ejection fraction (r = 0.65, p < 0.0001). Furthermore, the change in ejection fraction from baseline to after bypass surgery was highly correlated with the change in ejection fraction after amrinone stimulation (r = 0.75, p < 0.0001). Of 13 patients with an increase in ejection fraction > or = 10% after amrinone, all 13 had an increase of at least 8% and 11 (85%) of 13 had an increase > or = 10% after bypass surgery. In contrast, of 31 patients with an increase in ejection fraction < 10% after amrinone, only 2 (6%) had an increase > or = 10% (p < 0.0001) and 28 (90%) of 31 had an increase < 5% after bypass surgery. CONCLUSIONS:
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Authors | N A Perez-Baliño, O H Masoli, A H Meretta, A Rodriguez, D E Cragnolino, S Perrone, F Boullon, E Mele, I Palacios, K A Brown |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 28
Issue 6
Pg. 1488-92
(Nov 15 1996)
ISSN: 0735-1097 [Print] United States |
PMID | 8917262
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Cardiotonic Agents
- Amrinone
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Topics |
- Aged
- Aged, 80 and over
- Amrinone
(pharmacology)
- Cardiotonic Agents
(pharmacology)
- Coronary Artery Bypass
- Coronary Disease
(physiopathology, surgery)
- Female
- Hemodynamics
(drug effects)
- Humans
- Male
- Middle Aged
- Stroke Volume
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