The effects of dopamine on depressed myocardial function following coronary embolization in the closed-chest dog

Lipp, Harry; Falicov, Raul E.; Resnekov, Leon; King, Sheila

doi:10.1016/0002-8703(72)90335-3

Cited by 20 publications

(5 citation statements)

References 27 publications

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“…Dopamine is now administered frequently because it increases myocardial contractility and cardiac output (CO) with less alpha adrenergic vasoconstriction than norepinephrine and less cardiac acceleration than isoproterenol (10,11). Nevertheless, dopamine exerts considerable alpha adrenergic stimulation (12,13) and this property in combination with its tendency to elicit arrhythmias may limit its usefulness (14,15) 8,20, and 40 gg/kg in 13 dogs. This sequence was repeated while maintaining HR constant by electrical stimulation of the atria in seven dogs, and after beta adrenergic blockade with propranolol, 1-2 mg/kg, in nine dogs.…”

Section: Introductionmentioning

confidence: 99%

Effects of Dobutamine on Left Ventricular Performance, Coronary Dynamics, and Distribution of Cardiac Output in Conscious Dogs

Vatner¹,

McRitchie²,

Braunwald³

1974

J. Clin. Invest.

212

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The effects of dobutamine ([±] ¶4-[2- [[3-(p-hydroxyphenyl itg/kg/min, the drug increased dP/dt/P from 65±3 to 128i4 s' and isolength velocity from 72±4 to 120+7 mm/s without affecting LV end diastolic D significantly. Mean arterial P rose from 92±2 to 104±3 mm Hg and heart rate from 78±3 to 111+7 beats/min, while LV end systolic D fell from 24.1±+1.4 to 19.9±1.8 mm, reflecting a rise in stroke volume from 30±4 to 42±3 ml. Cardiac output rose from 2.41±0.23 to 4.35±0.28 liter/min, while calculated total peripheral resistance declined from 0.042+0.005 to 0.028±0.003 mm Hg/ml/min. The greatest increases in flow and decreases in calculated resistance occurred in the iliac and coronary beds, and the least occurred in the renal bed. Propranolol blocked the inotropic and betas dilator responses while vasoconstricting effects mediated by alpha adrenergic stimulation remained in each of the beds studied. When dobutamine was infused after a combination of practolol and phentolamine, dilatation occurred in each of the beds studied. These observations indicate that dobutamine is iDr.

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Section: Introductionmentioning

confidence: 99%

Effects of Dobutamine on Left Ventricular Performance, Coronary Dynamics, and Distribution of Cardiac Output in Conscious Dogs

Vatner¹,

McRitchie²,

Braunwald³

1974

J. Clin. Invest.

212

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“…Studies conducted in man (Horwitz et al, 1962;Loeb et al, 1975;Meyer et al, 1976;Goldberg, 1972) and in conscious animals (Goldberg, 1972;Vatner et al, 1973;Vatner et al, 1974a;Cobb et al, 1972) without myocardial ischemia consistently have shown increases in cardiac output, stroke volume, LV dP/dt, and coronary perfusion after administration of either dopamine or dobutamine. However, in the presence of myocardial ischemia, the effects of these drugs are controversial; studies have shown that these drugs improve (Turtle et al, 1977;Lipp et al, 1972;Willerson et al, 1976) and do not change (Gillespie et al, 1977;McClenathan et al, 1977;Ramanthan et al, 1977), or exacerbate (Mueller et al, 1978) the ischemic condition. The disparate effects of dopamine and dobutamine on ischemic myocardial function may be due to differences in dose, the presence of anesthesia and recent surgery in animal experiments, or the lack of directly measured regional myocardial function in conscious animals or man.…”

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confidence: 99%

Importance of heart rate in determining the effects of sympathomimetic amines on regional myocardial function and blood flow in conscious dogs with acute myocardial ischemia.

Vatner¹,

Baig²

1979

Circulation Research

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We examined the effects of dopamine (DP), dobutamine (DB), and isoproterenol (ISO) in 38 conscious dogs after coronary artery occlusion on measurements of overall left ventricular (LV) function (i.e., LV pressure, dP/dt, mean arterial pressure, and heart rate), while regional myocardial function was assessed, using an ultrasonic gauge to measure segment length (SL) in normal and ischemic areas of myocardium. We measured regional myocardial blood flow, using the radioactive microsphere technique. Coronary occlusion resulted in graded reductions of blood flow and function from the normal to severely ischemic zones. DP and DB, 4.0 pg/kg per min, and ISO, 0.03 fig/kg per rain, iv, increased LV dP/dt similarly; i.e., by 20%, and increased blood flow and systolic SL shortening in the normal zone. ISO increased heart rate (29.9 ± 4.6%) and decreased SL shortening and blood flow (32.9 ± 6.1%) in the severely ischemic zone. In contrast, we observed significantly different (P < 0.01) effects with these doses of DP and DB, which caused no increases in heart rate or decreases in blood flow or contractile function in the ischemic zone. DP and DB, 10 pg/kg per min, iv, increased LV dP/dt 3-to 4-fold more than with the lower dose, but still failed to elicit reductions in contractile function or blood flow in the severely ischemic zone when heart rate did not rise. In contrast, when the same doses of DP and DB increased heart rate in another group of dogs, blood flow and contractile function fell in the ischemic zone. Thus, /J-adrenergic agents do not always elicit a "coronary steal" or deleterious effects on ischemic myocardial function, despite coronary dilation in the normal zone. However, when inotropic stimulation is coupled with tachycardia, blood flow falls and contractile function deteriorates in the ischemic myocardium. Circ Res 45: 793-803, 1979

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“…Peripherally, it induces beta-adrenergic vasodilatation, diverting cardiac output to noncritical tissues while lowering arterial and coronary perfusion pressure (Elliott and Gorlin, 1966;Gunnar et al, 1967). In patients with coronary artery disease it may worsen myocardial ischaemia and increase infarct size (Maroko et al, 1971;Lipp et al, 1972). Dopamine is associated with considerably less chronotropic effect, but still may produce ventricular arrhythmias (Lipp et al, 1972;Gunnar and Loeb, 1972 Received for publication 29 June 1976 specific dopamine receptors, it has a predominantly alpha-adrenergic action on other arterial beds and may produce excessive vasoconstriction in high doses (McNay et al, 1965;Goldberg, 1972;Vatner et al, 1973).…”

mentioning

confidence: 99%

“…In patients with coronary artery disease it may worsen myocardial ischaemia and increase infarct size (Maroko et al, 1971;Lipp et al, 1972). Dopamine is associated with considerably less chronotropic effect, but still may produce ventricular arrhythmias (Lipp et al, 1972;Gunnar and Loeb, 1972 Received for publication 29 June 1976 specific dopamine receptors, it has a predominantly alpha-adrenergic action on other arterial beds and may produce excessive vasoconstriction in high doses (McNay et al, 1965;Goldberg, 1972;Vatner et al, 1973). More importantly, dopamine's inotropic effect is mediated in part through the release of endogenous noradrenaline (Tsai et al, 1967;Nash .et al, 1968).…”

mentioning

confidence: 99%

Comparison of dobutamine and dopamine in treatment of severe heart failure.

Stoner¹,

Bolen²,

Harrison³

1977

Heart

117

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The haemodynamic effects of dobutamine, a new synthetic catecholamine, were studied in 12 patients with severe congestive heartfailure and compared with those of dopamine in 10 clinically similar patients. Dobutamine produced a distinct increase in cardiac index, while lowering left ventricular end-diastolic pressure and leaving mean aortic pressure unchanged. Dopamine also significantly improved cardiac index, but at the expense of a greater increase in heart rate than occurred with dobutamine. Dopamine was ineffective in lowering left ventricular end-diastolic pressure, but increased mean aortic pressure. We conclude that dobutamine is an effective, positive inotropic agent in patients with severe congestive heart failure. Because it has comparatively little effect on heart rate and aortic pressure, both major determinants of myocardial oxygen consumption, it may be of special value in patients with the low output syndrome associated with coronary heart disease.

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The effects of dopamine on depressed myocardial function following coronary embolization in the closed-chest dog

Cited by 20 publications

References 27 publications

Effects of Dobutamine on Left Ventricular Performance, Coronary Dynamics, and Distribution of Cardiac Output in Conscious Dogs

Effects of Dobutamine on Left Ventricular Performance, Coronary Dynamics, and Distribution of Cardiac Output in Conscious Dogs

Importance of heart rate in determining the effects of sympathomimetic amines on regional myocardial function and blood flow in conscious dogs with acute myocardial ischemia.

Comparison of dobutamine and dopamine in treatment of severe heart failure.

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