Age-dependent effects of milrinone and levosimendan on ventricular function and haemodynamics in newborn and mature pigs
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Age-dependent effects of milrinone and levosimendan on ventricular function and haemodynamics in newborn and mature pigs. / Hyldebrandt, Janus A; Larsen, Signe H; Schmidt, Michael R; Hjortdal, Vibeke E; Ravn, Hanne B.
In: Cardiology in the Young, Vol. 21, No. 5, 10.2011, p. 518-27.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Age-dependent effects of milrinone and levosimendan on ventricular function and haemodynamics in newborn and mature pigs
AU - Hyldebrandt, Janus A
AU - Larsen, Signe H
AU - Schmidt, Michael R
AU - Hjortdal, Vibeke E
AU - Ravn, Hanne B
PY - 2011/10
Y1 - 2011/10
N2 - Inodilators are used in the treatment of low cardiac output, mainly after cardiac surgery. At present, there is little knowledge of the effect of inodilators in the newborn heart. Immediately after birth and in the neonatal period, the metabolism and physiology of the heart undergo major changes. We hypothesised that effects of the inodilators milrinone and levosimendan on myocardial contractility and haemodynamics under normal physiological conditions were age dependent. Animal studies were conducted on 48 pigs using a closed-chest biventricular conductance catheter method. Pigs in two age groups, that is, 5-6 days and 5-6 weeks, were assigned to milrinone, levosimendan, or a control group. We observed that both milrinone - 19.2% with a p value of 0.05 - and levosimendan - 25.7% with a p value of 0.03 compared with the control group increased cardiac output, as well as myocardial contractility with a maximum pressure development over time: milrinone 28.2%, p = 0.01 and levosimendan 19.4%, p = 0.05. Milrinone improved diastolic performance (p < 0.05) in the left ventricle in the 5-6-week-old animals. In the newborn animals, neither of the inodilators increased ventricular contractility or cardiac output; however, we observed a significant decrease in the mean arterial pressure: milrinone 34.6%, p < 0.01 and levosimendan 30.1%, p = 0.02. Both inodilators demonstrated age-dependent haemodynamic effects, and it is noteworthy that neither milrinone nor levosimendan was able to increase cardiac output in the newborn heart.
AB - Inodilators are used in the treatment of low cardiac output, mainly after cardiac surgery. At present, there is little knowledge of the effect of inodilators in the newborn heart. Immediately after birth and in the neonatal period, the metabolism and physiology of the heart undergo major changes. We hypothesised that effects of the inodilators milrinone and levosimendan on myocardial contractility and haemodynamics under normal physiological conditions were age dependent. Animal studies were conducted on 48 pigs using a closed-chest biventricular conductance catheter method. Pigs in two age groups, that is, 5-6 days and 5-6 weeks, were assigned to milrinone, levosimendan, or a control group. We observed that both milrinone - 19.2% with a p value of 0.05 - and levosimendan - 25.7% with a p value of 0.03 compared with the control group increased cardiac output, as well as myocardial contractility with a maximum pressure development over time: milrinone 28.2%, p = 0.01 and levosimendan 19.4%, p = 0.05. Milrinone improved diastolic performance (p < 0.05) in the left ventricle in the 5-6-week-old animals. In the newborn animals, neither of the inodilators increased ventricular contractility or cardiac output; however, we observed a significant decrease in the mean arterial pressure: milrinone 34.6%, p < 0.01 and levosimendan 30.1%, p = 0.02. Both inodilators demonstrated age-dependent haemodynamic effects, and it is noteworthy that neither milrinone nor levosimendan was able to increase cardiac output in the newborn heart.
KW - Age Factors
KW - Animals
KW - Animals, Newborn
KW - Cardiotonic Agents/pharmacology
KW - Hemodynamics/drug effects
KW - Hydrazones/pharmacology
KW - Milrinone/pharmacology
KW - Pyridazines/pharmacology
KW - Simendan
KW - Swine
KW - Vasodilator Agents/pharmacology
KW - Ventricular Function/drug effects
U2 - 10.1017/S1047951111000357
DO - 10.1017/S1047951111000357
M3 - Journal article
C2 - 21733205
VL - 21
SP - 518
EP - 527
JO - Cardiology in the Young
JF - Cardiology in the Young
SN - 1047-9511
IS - 5
ER -
ID: 242712224