Amrinone and exercise performance in patients with chronic heart failure

Karl Weber, Virginia Andrews, Joseph S. Janicki, John R. Wilson, Alfred P. Fishman

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)164-169
Number of pages6
JournalThe American Journal of Cardiology
Volume48
Issue number1
DOIs
StatePublished - Jan 1 1981
Externally publishedYes

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Amrinone
Heart Failure
Exercise
Cardiotonic Agents
Pulmonary Wedge Pressure
Vascular Resistance
Heart Rate
Hemodynamics
Oxygen
Exercise Therapy
Digitalis
Vasodilator Agents
Diuretics
Intravenous Administration
Cardiac Output
Ventilation
Arterial Pressure
Therapeutics
Body Weight

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Amrinone and exercise performance in patients with chronic heart failure. / Weber, Karl; Andrews, Virginia; Janicki, Joseph S.; Wilson, John R.; Fishman, Alfred P.

In: The American Journal of Cardiology, Vol. 48, No. 1, 01.01.1981, p. 164-169.

Research output: Contribution to journalArticle

Weber, Karl ; Andrews, Virginia ; Janicki, Joseph S. ; Wilson, John R. ; Fishman, Alfred P. / Amrinone and exercise performance in patients with chronic heart failure. In: The American Journal of Cardiology. 1981 ; Vol. 48, No. 1. pp. 164-169.
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