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Additive positive inotropic effects of milrinone, ouabain and calcium in diseased human ventricular myocardium

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Summary

The interactions of milrinone, ouabain and calcium on force of contraction in isolated, contracting human papillary muscle strips were measured. Milrinone (EC50, 8 × 10−5 M) increased force of contraction maximally by 2.8±0.8 mN at 5 × 10−4M; significantly less than either ouabain (1 × 10−7M; 4.8±0.5 mN increase) or calcium (15 mM; 6.2±0.6 mN increase). A submaximal, but not a maximal, inotropic effect of ouabain could be increased by the addition of milrinone; in contrast, both ouabain and calcium increased the maximal inotropic effect of milrinone by 1.7±0.2 mN and 2.7±0.3 mN, respectively. The combined inotropic effect of milrinone with either ouabain of 4.2±0.3 mN or calcium of 5.6±0.4 mN was not different from that with calcium or ouabain alone. We conclude that further positive inotropic effects should be expected when digitalis is given to patients with congestive heart failure who are already optimally treated with milrinone.

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Abbreviations

K D :

dissociation constant

(Na+ + K+)-ATPase:

sodium and potassium activated adenosine triphosphatase (EC 3.6.1.3)

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Authors and Affiliations

  1. Klinikum Großhadern, Medizinische Klinik I der Universität, München

    L. Brown, M. Näbauer & E. Erdmann

Authors
  1. L. Brown
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  2. M. Näbauer
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  3. E. Erdmann
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Additional information

This study was carried out using human heart samples provided by: Prof. E. Kreuzer, Prof. B. Kemkes, Dr. C. Weinhold and their colleagues, Herzchirurgische Klinik der Universität, Klinikum Großhadern, München

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Brown, L., Näbauer, M. & Erdmann, E. Additive positive inotropic effects of milrinone, ouabain and calcium in diseased human ventricular myocardium. Klin Wochenschr 64, 708–712 (1986). https://doi.org/10.1007/BF01712056

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  • DOI: https://doi.org/10.1007/BF01712056

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