Treating metabolic impairment and myocardial stunning with phosphodiesterase inhibitor type III, milrinone, administered prior to coronary artery occlusion in the presence of calcium channel blockade in pigs.
This study examined milrinone effects on ischaemic myocardial metabolism and function with calcium blockade. We studied 15 pigs in 3 groups: group C received no drugs; group D received diltiazem 5 mg bolus followed by infusion; group D+M received diltiazem and milrinone (50microg/Kg). The left anterior descending (LAD) artery was then occluded for 15 minutes. Left ventricular (LV) function data obtained included rate, pressures, output, Emax, and dP/dT. Blood lactate was obtained from the LAD and circumflex vessels at baseline, end of occlusion, early (15 min) and late (1 hour) reperfusion. In group D+M, less depression of LV function occurred during ischaemia and early reperfusion. Lactate extraction in the LAD region was less negative in D+M group than in the group without milrinone during ischaemia and late reperfusion. We conclude the preemptive administration of milrinone prior to ischaemia added to calcium blockade improved myocardialfunction and ischaemic metabolic effects.
Sidi
Avner
A
Department of Anesthesiology, University of Florida College of Medicine and Anesthesia Service, Malcom Randall Veterans Administration Medical Center, Gainesville, Florida, USA. Asidi@anest.ufl.edu
Muehlschlegel
Jochen D
JD
Muehschlegel
Jochen D
JD
Kirby
David S
DS
Lobato
Emilio B
EB
D000704:Analysis of Variance; D000818:Animals; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D002302:Cardiac Output / Q000187:drug effects; D002316:Cardiotonic Agents / Q000494:pharmacology*; D023921:Coronary Stenosis / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism* / Q000503:physiopathology; D004110:Diltiazem / Q000494:pharmacology; D004195:Disease Models, Animal; D006339:Heart Rate / Q000187:drug effects; D019344:Lactic Acid / Q000097:blood; D020105:Milrinone / Q000494:pharmacology*; D009200:Myocardial Contraction / Q000187:drug effects; D015425:Myocardial Reperfusion; D017682:Myocardial Stunning / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology*; D012107:Research Design; D013552:Swine; D013997:Time Factors; D014655:Vascular Resistance / Q000187:drug effects; D016277:Ventricular Function, Left / Q000187:drug effects; D017725:Ventricular Pressure / Q000187:drug effects
D015415:Biomarkers; D002121:Calcium Channel Blockers; D002316:Cardiotonic Agents; D010726:Phosphodiesterase Inhibitors; D019344:Lactic Acid; D004110:Diltiazem; D020105:Milrinone