Baroreflex sensitivity might predict responders to milrinone in patients with heart failure

Takuya Kishi, Kenji Sunagawa

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    1 Citation (Scopus)

    Abstract

    The phosphodiesterase III inhibitor milrinone (MIL) is considered to be effective for "wet and cold" heart failure. In some cases, however, the inotropic effects of milrinone are insuffcient. A previous study suggested that barorefex sensitivity (BRS) predicts the cases in which MIL increases left ventricular dp/dt. The aim of this study was to determine whether BRS measured using the spontaneous sequence method predicts the MIL responders. Twenty-four patients with "wet and cold" heart failure whose systolic blood pressure > 100 mmHg were enrolled. At 2 hours MIL improved dyspnea, general fatigue, urine volume, and tricuspid regurgitant pressure gradient in 13 patients (responders; R group), whereas it failed to improve in 11 patients (nonresponders; NR group). BRS in the R group was significantly higher than that in the NR group prior to the MIL infusion. At 2 hours after the MIL infusion, BRS was further increased in the R group, but did not increase in the NR group. The sensitivity and specificity of BRS at a cut-off level of 5 ms/mmHg for the prediction of R group were 0.94 and 0.93, respectively. BRS might be useful for identifying potential responders to milrinone in patients with blood pressure-preserved "wet and cold" heart failure.

    Original languageEnglish
    Pages (from-to)411-415
    Number of pages5
    JournalInternational heart journal
    Volume51
    Issue number6
    DOIs
    Publication statusPublished - 2010

    All Science Journal Classification (ASJC) codes

    • Cardiology and Cardiovascular Medicine

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