[Oral and injectable amrinone in cardiac insufficiency]

The authors report the results of a study of amrinone which was prescribed orally and by injection. 12 patients with stage III congestive heart failure were treated with oral amrinone. Prior to inclusion in the trial, all of the patients underwent a complete clinical, radiological and laboratory examination. They were examined by ergometric haemodynamic tests with measurement of the cardiac output and by echocardiography. After discharge from hospital, the patients were reviewed clinically every week and cyclo-ergometric and echocardiographic examinations were performed at 4, 8 and 12 weeks. At the end of the study, a further haemodynamic survey was performed in 8 patients. Two patients left the trial because of thrombocytopenia which appeared between the 10th and 25th day of treatment and 2 others left the trial (1 death, 1 treatment failure). In the 8 patients who completed the trial, the authors found: a functional improvement (improvement by one NYHA class within 3 months), a mean gain of 40 Watts at the last stress test, an 11% improvement in the ejection fraction and in the rate of circumferential shortening, a decrease in the filling pressure (16 mm Hg) and an improvement in the cardiac index (mean of 700 ml). A haemodynamic study was conducted in 4 patients who received amrinone by injection (1 mg/kg by slow intravenous injection, followed by an infusion of 10 ng/kg/min). The authors observed a mean drop in left ventricular end-diastolic pressure of 9 mm Hg an increase in the cardiac index of 1.02 l/min/m2, without any significant variation in the mean blood pressure or the heart rate.