Influence of dobutamine on regional myocardial blood flow and ventricular performance during acute and chronic myocardial ischemia in dogs.

Willerson, James T.; Hutton, I.; Watson, John T.; Platt, Melvin R.; Templeton, G. H.

doi:10.1161/01.cir.53.5.828

Cited by 102 publications

(28 citation statements)

References 11 publications

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“…With prenalterol, 20 jig kg-', both RMBF and regional contractility were decreased, a picture similar to that observed with atrial pacing at 175 beats min-'. These results must be considered in the light of those previously reported in anaesthetized (Marshall & Parratt, 1976;Willerson et al, 1976;Warltier et al, 1981;Rude etal., 1982Rude etal., , 1983 or in conscious dogs (Vatner & Baig, 1979;Liang et al, 1981) treated with dobutamine or dopamine during coronary artery occlusion or stenosis. Despite some differences, all these studies concluded that P-adrenoceptor agonists that induce coronary vasodilatation do not always cause a 'coronary steal phenomenon' nor necessarily enhance myocardial injury providing that coronary perfusion pressure is maintained and above all that tachycardia remains limited.…”

Section: Discussionsupporting

confidence: 60%

Influence of heart rate on the effects of prenalterol on regional myocardial blood flow and function during coronary stenosis in dogs

Berdeaux

Bonhenry

Duhaze

et al. 1984

British J Pharmacology

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1 The effects of prenalterol, a selective 31-adrenoceptor agonist with potent cardiac positive inotropic properties have been investigated on regional myocardial blood flow (RMBF) (microspheres) and contractile function (ultrasonic crystals) during partial circumflex coronary artery stenosis in 8 open-chest anaesthetized dogs. 2 Prenalterol was investigated at two intravenous doses: 5 gg kg-', which increased myocardial contractility (dP/dt max: +29%) more than heart rate (+12%, up to 150 beatsmin-') and 20 jig kg-1 which induced almost similar increases in contractility (+35%) and heart rate (+ 31% up to 175 beats min-1). The induced modifications of regional flow and function were then compared to those produced in another series of 6 dogs by atrial pacing at 150 and 175 beats min-1 respectively. 3 Prenalterol significantly increased RMBF and segment length (SL)-shortening in a dosedependent manner in the nonischaemic zone. In the ischaemic zone, RMBF was maintained and SL-shortening increased with prenalterol, 5 gig kg-' whereas both RMBF and contractile function were severely decreased with prenalterol, 20 gg kg-'. 4 Atrial pacing had almost no effect on RMBF and SL-shortening in the nonischaemic zone. In the ischaemic zone, atrial pacing rate-dependently decreased both RMBF and SL-shortening. 5 Thus, a significant increase in contractility, associated with little tachycardia (prenalterol, 5 fig kg-), induces beneficial effects on RMBF and function in both the nonischaemic and ischaemic myocardium. In contrast, a strong tachycardia, whether accompanied by positive inotropic effects (prenalterol, 20 gig kg-') or not (atrial pacing at 175 beats min-1) induces deleterious effects on RMBF and cardiac function in the ischaemic myocardium.

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Section: Discussionsupporting

confidence: 60%

Influence of heart rate on the effects of prenalterol on regional myocardial blood flow and function during coronary stenosis in dogs

Berdeaux

Bonhenry

Duhaze

et al. 1984

British J Pharmacology

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“…Thus, dobutamine use may potentially be detrimental in patients with limited coronary artery reserve in whom oxygen delivery cannot rise adequately to meet additional myocardial oxygen demand. 3 Amrinone, a nonglycosidic, nonadrenergic, cardiotonic agent, selectively inhibits type III phosphodiesterase. 4 When administered intravenously to patients with congestive heart failure, amrinone produces increases in cardiac performance similar in magnitude to the effect seen with dobutamine.7-10 In addition to its positive inotropic action, amrinone causes substantial arterial and venous vasodilation, and thus reduces both cardiac afterload and preload.…”

mentioning

confidence: 99%

Additive effects of dobutamine and amrinone on myocardial contractility and ventricular performance in patients with severe heart failure.

Gage¹,

Rutman²,

Lucido³

et al. 1986

Circulation

165

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The effects of amrinone, dobutamine, and a combination of the two drugs on peak positive left ventricular dP/dt and left ventricular performance were evaluated in 11 patients with chronic congestive heart failure. When administered alone, both dobutamine (10.9 gg/kg/min) and intravenous amrinone (1.9 mg/kg/min) significantly increased left ventricular dP/dt and performance. When compared with dobutamine alone, the addition of amrinone resulted in further increases in left ventricular dP/dt and cardiac index (to 1319 ± 419 from 1202 ± 376 mm Hg/sec, p < .002, and to 3.56 ± 0.78 from 3.04 ± 0.67 liters/min/m2, p < .01, respectively). The combination also induced a further reduction in left ventricular end-diastolic pressure (to 15.3 ± 11.3 from 18.2 ± 10.3 mm Hg, p < .05) when compared with amrinone alone. The combination of dobutamine and amrinone increased heart rate slightly when compared with either drug alone, but did not further reduce systemic arterial pressure when compared with amrinone alone. The dose-response curve of left ventricular dP/dt and performance during titration of dobutamine with and without the addition of intravenous amrinone was evaluated in seven patients. The addition of amrinone to any dose of dobutamine produced higher cardiac index and lower systemic vascular resistance than dobutamine or amrinone alone. Thus, when compared with dobutamine alone in patients with chronic congestive heart failure, the addition of intravenous amrinone to dobutamine results in an additive improvement in left ventricular performance throughout the dose range. Circulation 74, No. 2, 367-373, 1986. DOBUTAMINE is a synthetic catecholamine that directly stimulates myocardial /,-adrenergic receptors.It has been used extensively to improve myocardial contractility and ventricular performance in patients with acute left ventricular dysfunction or decompensated congestive heart failure.", 2 Dobutamine is usually well tolerated. Through its effects on cardiac mechanics and hemodynamics, it has the potential to alter myocardial oxygen utilization (MVO2) in several different ways. By increasing contractility and heart rate, it may increase MVO2, but the simultaneous reduction in wall tension tends to lower oxygen use. In some situations the stimulation of contractility and heart rate may outweigh the reduction in wall tension to

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“…These factors include isoprenaline, ouabain and tachycardia (Maroko, Kjekshus, Sobel, Watanase, Covell, Ross & Braunwald, 1971) and (Redwood, Smith & Epstein, 1972). Dobutamine has been shown in both the anaesthetized and conscious dog, with myocardial ischaemia, to increase myocardial contractility as much if not more than myocardial blood flow and if heart rate were to increase in addition, then the extent of myocardial damage would be greater (Willerson et al, 1976). Thus, despite the lack of effect on heart rate, U.K. 14275 should be used with caution in patients with acute myocardial infarction unless there is evidence of left ventricular dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular effects of a new inotropic agent, U. K. 14275, in patients with coronary heart disease.

Hutton¹,

Hillis²,

Langhan³

et al. 1977

Brit J Clinical Pharma

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1 The chronotropic and inotropic properties of U.K. 14275, a phosphodiesterase inhibitor were assessed in patients with coronary heart disease. 2 Left ventricular function was assessed in eight patients with acute myocardial infarction using the non‐invasive measurement of systolic time intervals. 3 Twelve patients with angina pectoris were studied during diagnostic coronary arteriography. Left ventricular function was assessed using a high fidelity catheter tipped transducer in the left ventricle. 4 In both groups of patients U.K. 14275 infused intravenously in doses of 32, 64, 128 and 256 microgram kg‐1 bodyweight min‐1 enhanced the contractile state of the left ventricle without altering the heart rate.

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Influence of dobutamine on regional myocardial blood flow and ventricular performance during acute and chronic myocardial ischemia in dogs.

Cited by 102 publications

References 11 publications

Influence of heart rate on the effects of prenalterol on regional myocardial blood flow and function during coronary stenosis in dogs

Influence of heart rate on the effects of prenalterol on regional myocardial blood flow and function during coronary stenosis in dogs

Additive effects of dobutamine and amrinone on myocardial contractility and ventricular performance in patients with severe heart failure.

Cardiovascular effects of a new inotropic agent, U. K. 14275, in patients with coronary heart disease.

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