The effects of milrinone were studied in ferret papillary muscle stimulated at various rates and temperatures from 23° to 36° C. In voltage-clamp experiments, 50 μg/ml (0.237 mM) milrinone induced a 2.1-fold increase in calcium current at 28° or 36°C. At 50 μg/ml, milrinone transiently increased contractility in all muscles at 28° C, but its steady-state effect was either increased (+ 50%) or decreased (- 24.7%) steady-state twitch amplitude. A negative inotropic effect always occurred below 27°C. Milrinone decreased the total twitch duration and split the twitch into two components (P1 and P2) in the absence of any evidence of aberrant conduction. Increasing milrinone concentration from 50 to 300 μg/ml decreased P1 and increased P2. Ryanodine (100 mM) or caffeine (10 mM) suppressed P1. Contractions elicited after 30 seconds of rest were also biphasic in the presence of milrinone, but in its absence. P2 of post-rest contraction was increased by caffeine or calcium (10 mM) and decreased by cobalt (2 mM) when drugs were applied at the beginning of the rest. Ryanodine and caffeine also suppressed P1 of post-rest contraction. The evidence suggests that P1 may be caused by Ca release from the sarcoplasmic reticulum and P2 by increased Ca influx during the action potential via the calcium channel. It is also suggested that P2 may be present under control conditions, but to a lesser extent, and masked by a large P1.
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Malecot, C. O., Bers, D. M., & Katzung, B. G. (1986). Biphasic contractions induced by milrinone at low temperature in ferret ventricular muscle: Role of the sarcoplasmic reticulum and transmembrane calcium influx. Circulation Research, 59(2), 151–162. https://doi.org/10.1161/01.RES.59.2.151