Comparison of Continuous Milrinone Versus Dobutamine on Pulmonary Pressures in Patients With Advanced Heart Failure

ulmonary hypertension affects ~50% of patients with advanced heart failure (AHF) and can be a barrier to cardiac transplantation.While inotropes are commonly used in patients with low cardiac output, equipoise exists regarding the optimal agent, particularly in the context of concomitant pulmonary hypertension. 1There remains conflicting data on the hemodynamic effects of milrinone versus dobutamine.As such, we investigated the effects of longer-term continuous intravenous milrinone compared with dobutamine in patients with AHF awaiting cardiac transplantation.The data for this study are available from the corresponding author upon reasonable request.Adult patients with AHF on the Home Inotrope Program at the Alfred Hospital, Melbourne, Australia from January 2009 to May 2022 were included.Inotropes (milrinone or dobutamine) were commenced in the inpatient setting; then patients were discharged home with 24-hour inotrope infusion via continuous ambulatory delivery device through a peripherally inserted central line.Patients attended weekly face-to-face pharmacy, nurse, and medical review.Right heart catheterization and echocardiography is performed at baseline, 30 days and 3 months.Inotrope type is at the discretion of the treating cardiologist with dose according to symptoms and end organ function.Ventricular assist device was undertaken in patients who failed to stabilize, or continued