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The hemodynamic effects of milrinone (Mil) were studied in 11 patients with congestive heart failure (CHF) and New York Heart Association (NYHA) functional class II-IV before and after a 2-week treatment. The plasma concentration of Mil was also determined and its pharmacokinetics analyzed. The effect of a placebo was examined before the initiation of the treatment. At the onset, the hemodynamic effects of a single oral dose of Mil (7.5 mg) were evaluated. Mil increased the cardiac index significantly (p &lt; 0.05) 4 h after administrations from 2.3 +/- 0.4 to 2.9 +/- 0.6 L/min/m2. The pulmonary capillary wedge pressure (PCW) was lowered significantly by Mil (p &lt; 0.05) between 0.5 and 4 h after administration. After a 2-week treatment, the baseline PCW dropped (p &lt; 0.05) and the NYHA functional class improved in 10 patients. One patient remained in the same class (II). The improved NYHA class was maintained in 6 patients tested after a mean interval of 16 +/- 3 months. Single oral administration of Mil (7.5 mg) induced hemodynamic improvements after 2-week treatment and the drug also induced similar improvements even after the chronic oral therapy with Mil for 16 +/- 3 months. Pharmacokinetic analysis showed a significant increase in the area under the curve after 2 weeks of treatment. We conclude that Mil decreases the PCW and probably increases the cardiac index and thus improves the symptoms and NYHA functional class in patients with CHF.

Hemodynamic Effects of Milrinone in Patients with Congestive Heart Failure. Short- and Long-term Follow Up Studies.