Amrinone and exercise performance in patients with chronic heart failure.
Amrinone and exercise performance in patients with chronic heart failure.
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氨力农和慢性心力衰竭患者的运动表现。
DOI：
10.1016/0002-9149(81)90586-5
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
Fishman,AP
中科院分区：
文献类型：
--
作者：
Weber,KT;Andrews,V;Janicki,JS;Wilson,JR;Fishman,AP
强心剂是否能改善慢性心力衰竭患者的运动能力尚不清楚。因此，11例严重心力衰竭患者的循环和呼吸反应进行了评估，洋地黄，利尿剂和血管扩张剂难治性直立平板运动之前，24小时内和4周后的氨力农治疗。本研究的目的是确定氨力农治疗的能力，以改善这些患者的运动血流动力学，努力耐力和有氧能力。氨力农急性静脉给药（1.8 ± 0.1 mg/kg体重）产生了以下变化仰卧位休息期间血流动力学变量（平均值±平均值的标准误）;心脏指数增加（从2.04 ± 0.39升/分钟/平方米降至2.99 ± 0.38升/分钟/平方米; p <0.01）和肺楔压降低（从24 ± 6到14 ± 6 mm Hg; p <0.01），而不改变心率或平均动脉压。在服用氨力农后24小时内，楔压在运动开始时（从25 ± 7降至14 ± 7 mm Hg）和整个运动过程中（p <0.01）下降，而心输出量、动静脉氧差、心率、肺和全身血管阻力、最大摄氧量和通气模式的运动反应与对照值相似。然而，在氨力农治疗4周后，运动和有氧能力分别增加了44%和48%（p <0.03），而排便反应没有变化。因此，氨力农是一种强效强心剂，可在休息和运动时急性改善衰竭心脏的功能;治疗4周后，最大有氧能力增加。因此，氨力农似乎有望用于慢性心力衰竭患者的管理。
Whether cardiotonic agents can improve the ability of patients with chronic heart failure to exercise remains unknown. Accordingly, the circulatory and respiratory response of 11 patients with severe heart failure refractory to digitalis, diuretic drugs and vasodilators was assessed during upright treadmill exercise before, within 24 hours and after 4 weeks of therapy with amrinone. The purpose of this study was to determine the ability of amrinone therapy to improve exercise hemodynamics, effort tolerance and aerobic capacity of these patients. Acute intravenous administration of amrinone (1.8 ± 0.1 mg/kg body weight) produced the following changes (mean values ± standard error of the mean) in hemodynamic variables during supine rest; increased cardiac index (from 2.04 ± 0.39 to 2.99 ± 0.38 liters/min per m2; p <0.01) and reduced pulmonary wedge pressure (from 24 ± 6 to 14 ± 6 mm Hg; p <0.01) without altering heart rate or mean arterial pressure. Within 24 hours after administration of amrinone, wedge pressure decreased at the onset of (from 25 ± 7 to 14 ± 7 mm Hg) and throughout exercise (p <0.01), whereas the exercise response of cardiac output, arteriovenous oxygen difference, heart rate, pulmonary and systemic vascular resistances, maximal oxygen uptake and the pattern of ventilation remained similar to control values. However, after 4 weeks of amrinone therapy, exercise and aerobic capacities were increased 44 and 48 percent (p <0.03), respectively, whereas the ventilatory response was unchanged. Thus, amrinone is a potent cardiotonic agent that acutely improves the function of the failing heart at rest and during exercise; the maximal aerobic capacity was increased after 4 weeks of therapy. Amrinone therefore appears to hold promise for the management of patients with chronic heart failure.
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DOI：
10.1016/0002-9343(78)90701-5
发表时间：
1978
期刊：
The American journal of medicine
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