Systemic and regional hemodynamic effects of captopril and milrinone administered alone and concomitantly in patients with heart failure

T. H. LeJemtel, C. S. Maskin, D. Mancini, Lawrence Sinoway, H. Feld, B. Chadwick

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

The effects of milrinone and captopril on ventricular performance, renal blood flow, and femoral vein oxygen content were compared in 11 patients with severe chronic heart failure. The increase in stroke volume index was greater with milrinone than with captopril (28 ± 7 vs 24 ± 7 ml/m2; p < .05), while pulmonary capillary wedge pressures fell similarly (19 ± 10 vs 21 ± 7 mm Hg). Mean systemic arterial pressure decreased significantly from 84 ± 10 to 73 ± 11 mm Hg (p < .05) with captopril but did not with milrinone. Neither drug changed heart rate significantly. Although milrinone produced a greater improvement in ventricular performance than captopril, renal blood flow increased similarly with both drugs from 289 ± 78 to 417 ± 111 ml/min (p < .05) and from 278 ± 77 to 441 ± 115 ml/min (p < .05), respectively. Femoral vein oxygen content was increased by milrinone from 7.9 ± 2.6 to 9.8 ± 3.0 ml/100 ml (p < .05) and was not changed by captopril. In seven additional patients, intravenous milrinone, administered at the peak effect of captopril, further augmented stroke volume index from 24 ± 6 to 32 ± 6 ml/m2 (p < .05) and tended to reduce pulmonary capillary wedge pressure further from 20 ± 8 to 18 ± 9 mm Hg (p = NS). The addition of intravenous milrinone to captopril did not reduce mean systemic arterial pressure (71 ± 8 vs 71 ± 8 mm Hg) or significantly increase heart rate (89 ± 17 vs 92 ± 18 beats/min) when compared with captopril alone. Although renal blood flow was not further increased by the addition of intravenous milrinone to captopril, femoral vein oxygen content increased from 6.8 ± 1.9 to 9.9 ± 1.8 ml/100 ml (p < .05). Thus simultaneous administration of captopril and milrinone has synergistic effect on cardiac performance and complementary effects on the peripheral circulation.

Original languageEnglish (US)
Pages (from-to)364-369
Number of pages6
JournalCirculation
Volume72
Issue number2
DOIs
StatePublished - Jan 1 1985

Fingerprint

Milrinone
Captopril
Heart Failure
Hemodynamics
Femoral Vein
Renal Circulation
Pulmonary Wedge Pressure
Oxygen
Stroke Volume
Arterial Pressure
Heart Rate
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

LeJemtel, T. H. ; Maskin, C. S. ; Mancini, D. ; Sinoway, Lawrence ; Feld, H. ; Chadwick, B. / Systemic and regional hemodynamic effects of captopril and milrinone administered alone and concomitantly in patients with heart failure. In: Circulation. 1985 ; Vol. 72, No. 2. pp. 364-369.
@article{35e01a0f6d444385b627a8f44bda6500,
title = "Systemic and regional hemodynamic effects of captopril and milrinone administered alone and concomitantly in patients with heart failure",
abstract = "The effects of milrinone and captopril on ventricular performance, renal blood flow, and femoral vein oxygen content were compared in 11 patients with severe chronic heart failure. The increase in stroke volume index was greater with milrinone than with captopril (28 ± 7 vs 24 ± 7 ml/m2; p < .05), while pulmonary capillary wedge pressures fell similarly (19 ± 10 vs 21 ± 7 mm Hg). Mean systemic arterial pressure decreased significantly from 84 ± 10 to 73 ± 11 mm Hg (p < .05) with captopril but did not with milrinone. Neither drug changed heart rate significantly. Although milrinone produced a greater improvement in ventricular performance than captopril, renal blood flow increased similarly with both drugs from 289 ± 78 to 417 ± 111 ml/min (p < .05) and from 278 ± 77 to 441 ± 115 ml/min (p < .05), respectively. Femoral vein oxygen content was increased by milrinone from 7.9 ± 2.6 to 9.8 ± 3.0 ml/100 ml (p < .05) and was not changed by captopril. In seven additional patients, intravenous milrinone, administered at the peak effect of captopril, further augmented stroke volume index from 24 ± 6 to 32 ± 6 ml/m2 (p < .05) and tended to reduce pulmonary capillary wedge pressure further from 20 ± 8 to 18 ± 9 mm Hg (p = NS). The addition of intravenous milrinone to captopril did not reduce mean systemic arterial pressure (71 ± 8 vs 71 ± 8 mm Hg) or significantly increase heart rate (89 ± 17 vs 92 ± 18 beats/min) when compared with captopril alone. Although renal blood flow was not further increased by the addition of intravenous milrinone to captopril, femoral vein oxygen content increased from 6.8 ± 1.9 to 9.9 ± 1.8 ml/100 ml (p < .05). Thus simultaneous administration of captopril and milrinone has synergistic effect on cardiac performance and complementary effects on the peripheral circulation.",
author = "LeJemtel, {T. H.} and Maskin, {C. S.} and D. Mancini and Lawrence Sinoway and H. Feld and B. Chadwick",
year = "1985",
month = "1",
day = "1",
doi = "10.1161/01.CIR.72.2.364",
language = "English (US)",
volume = "72",
pages = "364--369",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

Systemic and regional hemodynamic effects of captopril and milrinone administered alone and concomitantly in patients with heart failure. / LeJemtel, T. H.; Maskin, C. S.; Mancini, D.; Sinoway, Lawrence; Feld, H.; Chadwick, B.

In: Circulation, Vol. 72, No. 2, 01.01.1985, p. 364-369.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Systemic and regional hemodynamic effects of captopril and milrinone administered alone and concomitantly in patients with heart failure

AU - LeJemtel, T. H.

AU - Maskin, C. S.

AU - Mancini, D.

AU - Sinoway, Lawrence

AU - Feld, H.

AU - Chadwick, B.

PY - 1985/1/1

Y1 - 1985/1/1

N2 - The effects of milrinone and captopril on ventricular performance, renal blood flow, and femoral vein oxygen content were compared in 11 patients with severe chronic heart failure. The increase in stroke volume index was greater with milrinone than with captopril (28 ± 7 vs 24 ± 7 ml/m2; p < .05), while pulmonary capillary wedge pressures fell similarly (19 ± 10 vs 21 ± 7 mm Hg). Mean systemic arterial pressure decreased significantly from 84 ± 10 to 73 ± 11 mm Hg (p < .05) with captopril but did not with milrinone. Neither drug changed heart rate significantly. Although milrinone produced a greater improvement in ventricular performance than captopril, renal blood flow increased similarly with both drugs from 289 ± 78 to 417 ± 111 ml/min (p < .05) and from 278 ± 77 to 441 ± 115 ml/min (p < .05), respectively. Femoral vein oxygen content was increased by milrinone from 7.9 ± 2.6 to 9.8 ± 3.0 ml/100 ml (p < .05) and was not changed by captopril. In seven additional patients, intravenous milrinone, administered at the peak effect of captopril, further augmented stroke volume index from 24 ± 6 to 32 ± 6 ml/m2 (p < .05) and tended to reduce pulmonary capillary wedge pressure further from 20 ± 8 to 18 ± 9 mm Hg (p = NS). The addition of intravenous milrinone to captopril did not reduce mean systemic arterial pressure (71 ± 8 vs 71 ± 8 mm Hg) or significantly increase heart rate (89 ± 17 vs 92 ± 18 beats/min) when compared with captopril alone. Although renal blood flow was not further increased by the addition of intravenous milrinone to captopril, femoral vein oxygen content increased from 6.8 ± 1.9 to 9.9 ± 1.8 ml/100 ml (p < .05). Thus simultaneous administration of captopril and milrinone has synergistic effect on cardiac performance and complementary effects on the peripheral circulation.

AB - The effects of milrinone and captopril on ventricular performance, renal blood flow, and femoral vein oxygen content were compared in 11 patients with severe chronic heart failure. The increase in stroke volume index was greater with milrinone than with captopril (28 ± 7 vs 24 ± 7 ml/m2; p < .05), while pulmonary capillary wedge pressures fell similarly (19 ± 10 vs 21 ± 7 mm Hg). Mean systemic arterial pressure decreased significantly from 84 ± 10 to 73 ± 11 mm Hg (p < .05) with captopril but did not with milrinone. Neither drug changed heart rate significantly. Although milrinone produced a greater improvement in ventricular performance than captopril, renal blood flow increased similarly with both drugs from 289 ± 78 to 417 ± 111 ml/min (p < .05) and from 278 ± 77 to 441 ± 115 ml/min (p < .05), respectively. Femoral vein oxygen content was increased by milrinone from 7.9 ± 2.6 to 9.8 ± 3.0 ml/100 ml (p < .05) and was not changed by captopril. In seven additional patients, intravenous milrinone, administered at the peak effect of captopril, further augmented stroke volume index from 24 ± 6 to 32 ± 6 ml/m2 (p < .05) and tended to reduce pulmonary capillary wedge pressure further from 20 ± 8 to 18 ± 9 mm Hg (p = NS). The addition of intravenous milrinone to captopril did not reduce mean systemic arterial pressure (71 ± 8 vs 71 ± 8 mm Hg) or significantly increase heart rate (89 ± 17 vs 92 ± 18 beats/min) when compared with captopril alone. Although renal blood flow was not further increased by the addition of intravenous milrinone to captopril, femoral vein oxygen content increased from 6.8 ± 1.9 to 9.9 ± 1.8 ml/100 ml (p < .05). Thus simultaneous administration of captopril and milrinone has synergistic effect on cardiac performance and complementary effects on the peripheral circulation.

UR - http://www.scopus.com/inward/record.url?scp=0021847329&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021847329&partnerID=8YFLogxK

U2 - 10.1161/01.CIR.72.2.364

DO - 10.1161/01.CIR.72.2.364

M3 - Article

VL - 72

SP - 364

EP - 369

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 2

ER -