Effects of amrinone, a phosphodiesterase inhibitor, on right ventricular/arterial coupling immediately after cardiac operations Yoshie Ochiai, MD, Shigeki.

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Presentation transcript:

Effects of amrinone, a phosphodiesterase inhibitor, on right ventricular/arterial coupling immediately after cardiac operations Yoshie Ochiai, MD, Shigeki Morita, MD, Yoshihisa Tanoue, MD, Yoshito Kawachi, MD, Ryuji Tominaga, MD, Hisataka Yasui, MD The Journal of Thoracic and Cardiovascular Surgery Volume 116, Issue 1, Pages 139-147 (July 1998) DOI: 10.1016/S0022-5223(98)70252-1 Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 1 An echocardiographic image in which the ABD outlines the blood-tissue interface, and the region of interest is circled in the right ventricular cavity. The right ventricular cross-sectional area signal appears at the bottom. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 139-147DOI: (10.1016/S0022-5223(98)70252-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 2 A time line of the protocol. The conventional hemodynamics data, steady-state beat right ventricular pressure-area data, and multiple pressure-area loops by the bolus nitroglycerin intravenously (IV) were measured at baseline, after nitroprusside infusion, at repeat baseline, and after amrinone infusion. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 139-147DOI: (10.1016/S0022-5223(98)70252-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 3 Representative recordings of right ventricular (RV) pressure-area loops before and after nitroprusside and amrinone administration obtained by the bolus nitroglycerin intravenously. Lines of the end-systolic pressure-area relation (Ees; solid lines) and lines of effective arterial elastance (Ea; dotted lines) are shown. In this case, amrinone increased Ees from 4.3 to 6.3 mm Hg/cm2, which implied the increase in right ventricular contractility. On the other hand, amrinone decreased Ea from 10.8 to 7.2 mm Hg/cm2, which implied right ventricular afterload reduction. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 139-147DOI: (10.1016/S0022-5223(98)70252-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 4 Changes in Ees, the intercept of ESPAR (Ao), the area associated with the Pes of 25 mm Hg (A25), EW, effective Ea, the ratio of Ea to Ees (Ea/Ees), PVA and the efficiency of energy transfer from PVA to EW (EW/PVA) after administration of nitroprusside and amrinone in the same patients with paired data sets. Mean ± SD values are also shown. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 139-147DOI: (10.1016/S0022-5223(98)70252-1) Copyright © 1998 Mosby, Inc. Terms and Conditions