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Second Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi 755-8505, Japan
Milrinone, a
phosphodiesterase 3 (PDE3) inhibitor, is known to enhance left
ventricular (LV) contractility by an inhibition of the breakdown of
cAMP through the mechanism inhibiting PDE3. However, it is unclear
whether milrinone also exerts positive lusitropy, like dobutamine.
Here, we assessed the effects of milrinone on in vivo LV relaxation, as
well as the Ca2+-ATPase activity and the Ca2+
uptake function of the cardiac sarcoplasmic reticulum (SR), compared with the effect of dobutamine on those functions. After
dobutamine (3 µg · kg
1 · min
1) was
administered, the peak value of the first derivative of LV pressure
(+dP/dt) increased by 46%, whereas the time constant (
)
of LV pressure decay decreased by 6.9%, respectively. After milrinone (10 µg/kg) was administered, the peak +dP/dt
increased to a similar extent as dobutamine (46%), whereas
decreased much more than dobutamine (19.9%; P < 0.05). In LV crude homogenate, the thapsigargin-sensitive,
Ca2+-ATPase activity-cAMP relationships was significantly
less increased by milrinone compared with dobutamine (P < 0.05), indicating the higher sensitivity of the SR
Ca2+-ATPase activity on cAMP by milrinone than by
dobutamine. In the SR vesicles purified from LV muscles, the
addition of cAMP increased the SR Ca2+ uptake in a
dose-dependent fashion, and the PDE3 inhibitors (milrinone and cGMP)
significantly augmented this response (P < 0.05).
Hence, milrinone substantially improved LV relaxation in association with an acceleration of the SR Ca2+-ATPase activity and the
SR Ca2+ uptake. This acceleration might be due to an
inhibition of the membrane-bound PDE3 in the SR, leading to a local
elevation of cAMP.
calcium; inotropic agent; ion pumps; ventricular function; phosphodiesterase 3
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