Influence of dobutamine on hemodynamics and coronary blood flow in patients with and without coronary artery disease

Meyer, S.; Curry, George C.; Donsky, Michael S.; Twieg, Donald B.; Parkey, Robert W.; Willerson, James T.

doi:10.1016/0002-9149(76)90070-9

Cited by 177 publications

(31 citation statements)

References 7 publications

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“…Patients with orthopedic or neurological conditions always preclude exercise be cause of poor cooperation and low motivation. Dobuta mine is a sympathomimetic agent which can increase heart rate and contractility, thus increasing the workload of the heart comparable to exercise testing [12][13][14], There is a striking increase in the use of dobutamine stress testYuan-Tch Lee. MD.…”

Section: Introductionmentioning

confidence: 99%

Dobutamine Stress Echocardiography for Detecting Coronary Artery Disease

Kao

et al. 1996

Cardiology

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To assess the value of dobutamine stress echocardiography (DSE) to detect coronary artery disease (CAD) and to compare the diagnostic accuracy between DSE and treadmill exercise test (TXT), 104 patients (mean age 58 ± 12 years) presenting for coronary angiography were prospectively studied. TXT was performed according to the Bruce protocol. Dobutamine (5-40 µg/ kg/min) was infused in 3-min stages. Digital echocardiograms were recorded on-line at baseline, during low- and peak-dose dobutamine infusion, and at recovery. An echocardiogram positive for CAD was defined as the one showing a new wall motion abnormality (WMA) induced by dobutamine. There were no major complications during the study. Significant CAD (≧ 50% diameter stenosis) was present in 17 of 30 patients who had normal echocardiograms at baseline. The sensitivity for detecting CAD was 76% by TXT and 94% by DSE, and the specificity was only 38% by TXT and 92% by DSE, respectively. Seventy-four patients had localized rest WMAs. Twenty-four had no significant CAD or lesions only confined to regions with abnormal rest wall motion, and 50 had disease remote from these regions. The sensitivity for detection of remote disease was 60% by TXT and 76% by DSE, and the specificity was 75% by TXT and 96% by DSE, respectively. In conclusion, DSE is a safe and accurate diagnostic tool for identifying CAD and for predicting the extent of disease in those who have localized rest WMAs.

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Section: Introductionmentioning

confidence: 99%

Dobutamine Stress Echocardiography for Detecting Coronary Artery Disease

Kao

et al. 1996

Cardiology

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“…Pulmonary artery pressure and LVEDP decreased dose-dependently during AR-L 115 BS infusion, but adverse effects on these parameters have been reported after dopamine (10,17,25), whereas there were no significant changes or an improvement after dobutamine (6,14). Although regional myocardial perfusion was not impaired during AR-Lll5BS infusion, further investigations are needed to evaluate the effects of the drug on myocardial performance when coronary inflow is restricted, since the adverse effects of positive inotropic agents on ischemic myocardium, probably due to the associated chronotropic actions, are well documented (18,19,29,35). However, combination of these positive inotropic agents with a negative chronotropic agent, which does not interfere with the positive inotropy, may offer an attractive addition of the treatment of myocardial pump failure.…”

Section: Discussionmentioning

confidence: 99%

Systemic and regional myocardial responses to AR-L 115 BS, a positive inotropic imidazo-pyridine, in the absence or in the presence of the bradycardiac action of alinidine

1981

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SummaryThe effects of the imidazo-pyridine AR-L 115 BS on global and regional myocardial function were investigated in anesthetized pigs in the absence and in the presence of the bradycardiac action of alinidine. AR-L 115 BS (0.1-0.8 mg 9 kg -1 9 rain -1) increased myocardial contractility (up to 75 %) and reduced preload (50 %) and afterload (50 %) in a dose-dependent manner. These changes were accompanied by moderate increases in heart rate (up to 20 %). The increase in cardiac output was only moderate (20 %), due to the reduction in preload. Renal blood flow increased slightly, but coronary blood flow was not significantly affected, due to the marked decrease in coronary vascular resistance (up to 50 %). Regional perfusion was not impaired as the endo/epi flow ratio was not affected and the coronary venous 02-saturation increased slightly but significantly. Myocardial wall thickness tracings (ultrasound principle) showed some pronounced changes. The positive inotropic action of AR-L 115 BS were best reflected by the changes in the velocity of wall thickening (up to 90 %, P < 0.001), and the timing of the occurrence of maximal wall thickness (maxT) with respect to aortic valve closure, as maxT, which occurred 5-10 msee after aortic valve closure during base line, preceded aortic valve closure with 45 msee after AR-L 115 BS (P < 0.001).Since the adverse effects of positive chronotropy on isehemie myocardium are well documented, AR-L 115 BS was also investigated in combination with alinidine, an agent which has predominantly negative chronotropie properties. This study revealed that alinidine did not interfere with the positive inotropic action of AR-L115BS but mainly reduced heart rate. Consequently, combination of the two drugs, which resulted in an improved myocardial function at a lower O2-demand, may offer an attractive addition in the treatment of myocardial pump failure.

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“…Bu olgularda aritmi beta reseptörlerinin stimulasyonuna ve dobutamine bağlı olarak gelişen serum potasyum düşüklüğüne bağlanmıştır. Ayrıca, dobutamin stres ekokardiyografi testi sırasında yeni miyokard enfarktüsü geçirenlerde, anginanın daha sık olduğu, ancak aritmi insidansında iki grup arasında fark bulunmadığı saptanmıştır 15 .…”

Section: Tartıșmaunclassified