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      Hemodynamic Effects and Pharmacokinetics of Oral Milrinone for Short-Term Support in Acute Heart Failure

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          The present study evaluated the acute hemodynamic response, effects on subjective symptoms and physical findings, and the pharmacokinetics of a single oral dose (2.5, 5, or 10 mg) of milrinone in 31 patients with acute or decom-pensated heart failure. We found a significant increase in cardiac index (29, 31, and 29%, respectively, p < 0.01) and a significant decrease in pulmonary capillary wedge pressure (39, 43, and 47%, respectively, p < 0.01) accompanied with improvement in subjective symptoms and physical findings. These hemodynamic effects persisted for 4-8 h after each dosage of milrinone. Dose-dependent hemodynamic response was observed between the drug concentration and percent maximum changes in pulmonary capillary wedge pressure (peak milrinone concentration, 2.5 mg: 99.99 ± 57.49, 5 mg: 187.11 ± 71.37, and 10 mg: 300.94 ± 158.5 ng/ml). The finding, together with results of the Prospective Randomized Milrinone Survival Evaluation (PROMISE) study, suggests lower dose of milrinone will be useful for the short-term inodilator support in patients with acute or decompensated heart failure.

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          Author and article information

          S. Karger AG
          18 November 2008
          : 86
          : 1
          : 34-40
          Japanese Oral Milrinone Hemodynamic Investigators: aNippon Medical School Hospital, bSurugadai Ninon University Hospital, cNihon University Hospital, dToho University Hospital, eTokyo Metropolitan Hiroo Hospital, fSakakibara Heart Institute, gOhgaki Municipal Hospital, Japan
          176828 Cardiology 1995;86:34–40
          © 1995 S. Karger AG, Basel

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          Page count
          Pages: 7
          Clinical Pharmacology


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