Short term effects of milrinone on biomarkers of necrosis, apoptosis, and inflammation in patients with severe heart failure.
Short term effects of milrinone on biomarkers of necrosis, apoptosis, and inflammation in patients with severe heart failure.
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Milrinone对严重心力衰竭患者坏死，凋亡和炎症生物标志物的短期影响。
DOI：
10.1186/1479-5876-7-67
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发表时间：
2009-07-29
影响因子：
7.4
通讯作者：
Sabbah HN
中科院分区：
文献类型：
--
作者：
Lanfear DE;Hasan R;Gupta RC;Williams C;Czerska B;Tita C;Bazari R;Sabbah HN
正性肌力药与心力衰竭（HF）的不良结局相关，引起了对它们可能加速心肌损伤的担忧。急性米力农给药后心肌坏死、炎症和细胞凋亡的生物标志物是否发生变化尚未明确。研究了10例接受米力农治疗的严重HF和心输出量减少的患者。在开始米力农给药前和输注24小时后采集血样。剂量由患者主治医生决定（范围为0.25-0.5 mcg/kg/min）。在两个时间点测量血浆肌钙蛋白、肌红蛋白、N-末端-pro-BNP、白细胞介素-6、肿瘤坏死因子-α、可溶性Fas和可溶性Fas配体。所有患者肌钙蛋白在基线时均升高（平均0.1259 ± 0.17 ng/ml），但米力农治疗24小时后无显著变化（平均0.1345 ± 0.16 ng/ml，p = 0.44）。与基线相比，白细胞介素-6、肿瘤坏死因子-α、可溶性Fas和可溶性Fas-配体显著改善（均p < 0.05），表明炎症和凋亡信号减少。总之，在严重心力衰竭和低心排血量的患者中，持续性心肌损伤很常见，开始使用米力农不会导致心肌损伤加剧，而是对其他生物标志物产生有益影响。
Inotropes are associated with adverse outcomes in heart failure (HF), raising concern they may accelerate myocardial injury. Whether biomarkers of myocardial necrosis, inflammation and apoptosis change in response to acute milrinone administration is not well established. Ten patients with severe HF and reduced cardiac output who were to receive milrinone were studied. Blood samples were taken just before initiation of milrinone and after 24 hours of infusion. Dosing was at the discretion of the patient's attending physician (range 0.25–0.5 mcg/kg/min). Plasma measurements of troponin, myoglobin, N-terminal-pro-BNP, interleukin-6, tumor necrosis factor-α, soluble Fas, and soluble Fas-ligand were performed at both time points. Troponin was elevated at baseline in all patients (mean 0.1259 ± 0.17 ng/ml), but there was no significant change after 24 hours of milrinone (mean 0.1345 ± 0.16 ng/ml, p = 0.44). There were significant improvements in interleukin-6, tumor necrosis factor-α, soluble Fas, and soluble Fas-ligand (all p < 0.05) indicative of reduced inflammatory and apoptotic signaling compared to baseline. In conclusion, among patients with severe HF and low cardiac output, ongoing myocardial injury is common, and initiation of milrinone did not result in exacerbation of myocardial injury but instead was associated with salutary effects on other biomarkers.
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影响因子：
8.8
作者：
Petersen, John W;Felker, G Michael
通讯作者：
Felker, G Michael
影响因子：
6
作者：
Sabbah, Hani N.;Wang, Mengjun;Brewer, Robert
通讯作者：
Brewer, Robert
DOI：
10.1016/s0735-1097(02)02968-6
发表时间：
2003-03-19
影响因子：
24
作者：
Felker, GM;Benza, RL;O'Connor, CM
通讯作者：
O'Connor, CM
影响因子：
3.1
作者：
ENDRES, S;SINHA, B;FULLE, HJ
通讯作者：
FULLE, HJ
影响因子：
9.6
作者：
Milani, RV;Mehra, MR;Ventura, HO
通讯作者：
Ventura, HO