Influence of short-term milrinone therapy on hemodynamics and heart function in patients with acute heart failure syndromes
Zhao Xia
Ren Haiming
Wang Mingsheng
Jin Bingshen
Abstract：Objective To observe the influence of intravenous injection of milrinone on hemodynamics and heart function in patients with acute heart failure syndromes (AHFS).Methods AHFS patients (n=120) were chosen from the Beijing Shijingshan Hospital from Sept. 2015 to Mar. 2017, and monitored with pulmonary artery catheter within 48 h after hospitalization. The patients were randomly divided into 4 groups: low-dose milrinone group (0.5 μg), mid-dose milrinone group (1.0 μg), high-dose milrinone group (1.5 μg) and placebo group (normal saline, eachn=30). Milrinone or normal saline were injected intravenously through infusion pump in a velocity of 100 mL/h for 6 h. The indexes of pulmonary capillary wedge pressure (PCWP), cardiac index (CI), mean right atrial pressure (MRAP), stroke work index (SWI), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were observed in all groups before and after treatment.Results In 120 patients, 105 were male ones and their average age=(55±11). The difference in sex, age, disease causes, baseline hemodynamics and heart function had no statistical significance among 4 groups (P>0.05). The change of PCWP was 0.0 mmHg in placebo group, -3.2 mmHg in low-dose milrinone group, -3.3 mmHg in mid-dose milrinone group and -4.7 mmHg in high-dose milrinone group after treatment. PCWP decreased significantly in all milrinone groups compared with placebo group (all P<0.05) showing a dose-independence. The systolic blood pressure increased significantly in mid-dose milrinone group and high-dose milrinone group, and was higher in high-dose milrinone group than that in mid-dose milrinone group (all P<0.05). The heart rate decreased in all milrinone groups compared with placebo group (all P<0.05) showing a dose-independence. CI increased in high-dose milrinone group compared with placebo group (P<0.05) and LVESV was significantly higher in mid-dose milrinone group than that in placebo group (P=0.03). The mean changes of CI and LVESV had no statistical difference among low-dose milrinone group, high-dose milrinone group and placebo group (P>0.05). The decrease of LVEDV was significantly higher in high-dose milrinone group than that in placebo group (P=0.02), while mean change of LVEDV had no statistical difference among low-dose milrinone group, mid-dose milrinone group and placebo group after treatment.Conclusion The high-dose milrinone can improve PCWP, promote systolic blood pressure and reduce heart rate in AHFS patients.
Keywords：MilrinoneAcute heart failure syndromesHemodynamicsHeart function
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 980-983 )