Cardiovascular centre is detected by baroreceptors in the aortic sinuses or carotid sinuses, the cardiovascular centre affects changes to the heart rate by sending a nerve impulse to the cardiac pacemaker (or SA node) via sympathetic fibres (to cause faster and stronger cardiac muscle contraction) and the vagus nerve (to cause slower and less strong cardiac muscle contraction). The cardiovascular centre also increases the stroke volume of the heart (that is, the amount of blood it pumps). These two changes help to regulate the cardiac output, so that a sufficient amount of blood reaches tissue. Hormones like epinephrine and norepinephrine can affect
Milrinone of the cardiomyocytes therefore increasing the rate at which cells can depolarize and generate contraction. PKA also phosphorylates components on myofilaments allowing actin and myosin to interact more easily and thus increasing contractility and the inotropic state of the heart. Milrinone allows stimulation of cardiac function independently of β-adrenergic receptors which appear to be down-regulated in those with heart failure. In recent years many studies have been performed showing that milrinone use may present potential adverse side effects in heart failure patients. Milrinone Milrinone, commonly known and marketed under the brand name Primacor, is a medication used in patients who