Effect of dobutamine on left ventricular relaxation and filling phase in patients with ischemic heart disease and preserved systolic function

Abstract

The beneficial effects of dobutamine on left ventricular systolic and diastolic phases have been described in patients with congestive heart failure. Its influence on left ventricular diastolic phase in patients with preserved systolic function, absence of dys- or akinetic areas, and left ventricular dilatation has not yet been adequately investigated. Thus a simultaneous echo-Doppler and hemodynamic study was performed in 15 patients with ischemic heart disease and preserved systolic function in order to assess the effect of dobutamine on left ventricular relaxation and filling phase. The infusion of dobutamine at a rate of 10 micrograms/kg/min induced a marked inotropic action, as shown by the significant increase in positive dP/dt (from 1392 +/- 224 to 2192 +/- 295 mmHg/sec, p < 0.001), dP/dt/P (from 32 +/- 8.1 to 50 +/- 17 sec-1; p < 0.0001), and in peak of systolic pressure (from 143 +/- 25 to 168 +/- 36 mmHg; p < 0.005). In addition, dobutamine reduced the end-systolic volume index (from 30 +/- 16 to 26 +/- 19 ml/m2; p < 0.05), the end-systolic stress (from 222.2 +/- 65.3 to 198.4 +/- 84 g/cm2; p < 0.006), and had favorable effects on relaxation and the early filling phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Left ventricular blood flow patterns at rest and under dobutamine stress in healthy pigs

“…This situation can partially be explained by the vigorous blood inflow with septally directed trajectory, but also by a reduced left ventricular volume (both LVEDV and LVESV). Although it has been known that in healthy humans LVEDV decreases and mitral inflow velocity increases under dobutamine in patients with LV dilation, such data are not available for pigs. Further, the effects of dobutamine infusion observed in this study have to be interpreted in the frame of general anaesthesia.…”

Medical Therapies to Improve Left Ventricular Outflow Obstruction and Diastolic Function in Hypertrophic Cardiomyopathy

“…These results also indirectly confirm the notion that beta agonists (ie, dobutamine) improve diastolic filling and reduce LV wall stress. 42 , 43 …”