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首页> 外文期刊>American Journal of Physiology >Effects of milrinone and epinephrine or dopamine on biventricular function and hemodynamics in an animal model with right ventricular failure after pulmonary artery banding
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Effects of milrinone and epinephrine or dopamine on biventricular function and hemodynamics in an animal model with right ventricular failure after pulmonary artery banding

机译：Milrinone和肾上腺素或多巴胺对肺动脉绑带右心室衰竭的动物模型中双心性功能和血流动力学的影响

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摘要

Right ventricular (RV) failure due to chronic pressure overload is a main determinant of outcome in congenital heart disease. Medical management is challenging because not only contractility but also the inter-ventricular relationship is important for increasing cardiac output. This study evaluated the effect of milrinone alone and in combination with epinephrine or dopamine on hemodynamics, ventricular performance, and the interventricular relationship. RV failure was induced in 21 Danish landrace pigs by pulmonary artery banding. After 10 wk, animals were reexamined using biventricular pressure-volume conductance catheters. The maximum pressure in the RV increased by 113% (P < 0.0001) and end-diastolic volume by 43% (P < 0.002), while left ventricular (LV) pressure simultaneously decreased (P = 0.006). Concomitantly, mean arterial pressure (MAP; -16%, P = 0.01), cardiac index (CI; -23%, P < 0.0001), and mixed venous oxygen saturation (Sv_(O_2); -40%, P < 0.0001) decreased. Milrinone increased CI (11%, P = 0.008) and heart rate (HR; 21%, P < 0.0001). Stroke volume index (SVI) decreased (7%, P = 0.03), although RV contractility was improved. The addition of either epinephrine or dopamine further increased CI and HR in a dose-dependent manner but without any significant differences between the two interventions. A more pronounced increase in biventricular contractility was observed in the dopamine-treated animals. LV volume was reduced in both the dopamine and epinephrine groups with increasing doses In the failing pressure overloaded RV, milrinone improved CI and increased contractility. Albeit additional dose-dependent effects of both epinephrine and dopamine on CI and contractility, neither of the interventions improved SVI due to reduced filling of the LV.
机译：由于慢性压力过载引起的右心室（RV）失败是先天性心脏病的结果的主要决定因素。医疗管理是具有挑战性的，因为不仅具有收缩性，而且间间关系对于增加心输出是重要的。该研究评估了Milrinone单独的影响，并与肾上腺素或多巴胺结合在血流动力学，心室性能和间隔关系中。肺动脉扎带21只丹麦地兰猪诱发了RV失败。在10WK之后，使用五圈压力量导管重新审视动物。 RV中的最大压力增加113％（P <0.0001），最终舒张体积增加43％（P <0.002），而左心室（LV）压力同时降低（P = 0.006）。伴随，平均动脉压（MAP; -16％，P = 0.01），心脏指数（CI; -23％，P <0.0001）和混合静脉氧饱和度（SV_（O_2）; -40％，P <0.0001）减少。 Milrinone增加Ci（11％，p = 0.008）和心率（HR; 21％，P <0.0001）。卒中体积指数（SVI）减少（7％，P = 0.03），但率改善了RV收缩性。以剂量依赖性方式添加肾上腺素或多巴胺进一步增加CI和HR，但在两个干预措施之间没有任何显着差异。在多巴胺处理的动物中观察到生物不良收缩性更明显的增加。多巴胺和肾上腺素组中的LV体积减少，在失效的压力下的液体过载的RV，MilRinone改善Ci和增加的收缩性时，所述剂量增加。尽管肾上腺和多巴胺对CI和收缩性的额外剂量依赖性作用，但由于降低了LV的填充，干预措施也不改善SVI。

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