[Efficacy of intravenous milrinone in the treatment of acute congestive cardiac failure. Results of a French multicenter study].
The hemodynamic effects and safety of milrinone, a phosphodiesterase inhibitor, were studied in 57 patients in the acute phase of cardiac failure. The drug was given intravenously as an initial push dose of 50 micrograms/kg in 10 min followed by a 24 hour infusion at the dose of 0.5 micrograms/kg/min. Maximal response was obtained after 15 min and persisted throughout the infusion. Cardiac index rose by 40%, while pulmonary capillary pressure fell from 25 mmHg to 17 mmHg (-30%) by the fifth minute of treatment. Mean pulmonary artery pressure fell by 20% by the 15th minute. Systemic resistance decreased by 26% and pulmonary vascular resistance by 22%. All these variations were significant. Heart rate and systemic blood pressure remained stable. Study of three sub-groups: digoxin vs non-digoxin, sinus rhythm vs atrial fibrillation, and coronary patients vs non-coronary patients, revealed no significant difference. Safety of the drug was good, no extra-cardiac actions having required interruption of the infusion. Stoppage was made necessary by two instances of ventricular tachycardia. Improved hemodynamic effects and the good safety/acceptability of the drug indicate that milrinone is a treatment of choice in cardiac failure.
Hôpital Henri Mondor, Creteil.
J L
JL
Dubois-Randé
C
C
Guérot
F
F
Jan
M
M
Brochier
A
A
Sacrez
A
A
Vacheron
M
M
Bory
H
H
Lambert
J C
JC
Pony
Y
Y
Le Bloc'h
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D020105:Milrinone; D011728:Pyridones / Q000494:pharmacology / Q000627:therapeutic use*
D002316:Cardiotonic Agents; D011728:Pyridones; D020105:Milrinone
Efficacité de la milrinone intraveineuse dans le traitement de l'insuffisance cardiaque congestive aiguë. Résultats d'une étude multicentrique française.