The use of dobutamine in myocardial infarction for reversal of the cardiodepressive effect of metoprolol.

Waagstein, Finn; Málek, I; Hjalmarson, Å

doi:10.1111/j.1365-2125.1978.tb01666.x

Cited by 18 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study it was found that dobutamine could reverse all the effects of the (-blocking agent metoprolol in patients with acute myocardial infarction (Waagstein et al, 1978). From animal experiments (Robie et al, 1974) it is known that dobutamine, in addition to its (l-stimulating action, also has a-receptor and P2-receptor stimulating effects.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic effects of a new beta 1-receptor agonist in acute myocardial infarction. A useful antidote to unwanted cardiac effects of beta-blocking agents.

Ariniego¹,

Waagstein²,

Mombay³

et al. 1979

Heart

Self Cite

View full text Add to dashboard Cite

SUMMARYThe haemodynamic effects of a new pl-receptor agonist, 1-(4 hydroxyphenoxy) 3-isopropylamino-2-propanol, were studied in 25 patients after acute myocardial infarction using non-invasive methods. The drug caused an increase in systolic blood pressure and pulse pressure, without change in diastolic blood pressure, and a slight increase in heart rate and reduction in the pre-ejection period. These changes were greater in patients without a history of left heart failure. It is suggested that this cardioselective drug possesses positive inotropic activity but only slight positive chronotropic activity. The substance has been further investigated as a possible antidote to unwanted cardiac side effects of the cardioselective p-blocker, metoprolol. The changes in the cardiovascular dynamics caused by metoprolol in patients with acute myocardial infarction were promptly reversed by this new PA-agonist.With its positive inotropic properties and its efficacy in reversing the effects of a cardioselective p-blocker, the drug is a potentially useful pharmacological agent to support an acutely depressed myocardium in patients on p-blocking agents.Myocardial failure is an important if not a major cause of mortality in acute myocardial infarction, and is related to the size of the infarct (Bolooki et al., 1971) and to the severity of the coronary artery disease (Wackers et al., 1976). Until a definitive form of treatment becomes available, pharmacological support of the failing myocardium is necessary. Beregovich and co-workers (1972) reported that short-term administration of catecholamines improved myocardial contractility after myocardial infarction. The substance racemic 1-(4 hydroxyphenoxy)-3-isopropylamino-2 propanol3 and its laevo form4, new compounds with (l-selective agonist activity, were investigated in animals by Carlsson et al. (1977) and in healthy volunteers by Johnsson et al. (1979) and Knaus et al. (1978). Preliminary investigations of their haemodynamic effects, using non-invasive methods in healthy subjects (Johnsson et al., 1979), showed a significant shortening of the pre-ejection period (PEP), left ventricular ejection time (LVET), and electromechanical systole, and a rise in the systolic blood pressure. There were no great changes in heart rate or diastolic blood pressure when the racemic form was given as an intravenous infusion in doses up to 20 ,ug per kg body weight or in oral doses of 2-5 to 20 mg. These findings indicate a selective inotropic action, making the substance a useful pharmacological agent to support a myocardium whose function has been depressed 'H 80/62, AB Hassle

show abstract

Section: Discussionmentioning

confidence: 99%

Haemodynamic effects of a new beta 1-receptor agonist in acute myocardial infarction. A useful antidote to unwanted cardiac effects of beta-blocking agents.

Ariniego¹,

Waagstein²,

Mombay³

et al. 1979

Heart

Self Cite

View full text Add to dashboard Cite

show abstract

“…An incidence of VEB of 44% is, however, not higher than expected in patients with recent AM1 (6). As pointed out by Waagstein et al (9), the action of dobutamine is probably energy-demanding, as in patients with "moderately severe" AM1 the shortening of PEPI is associated with an increase in heart rate and BP. However, AM1 patients with more severe signs of pump failure in the above study did not respond with pulse pressure or PEPI but did show a significant increase in heart rate.…”

Section: Resultsmentioning

confidence: 79%

“…The present data from patients with mild left heart failure after AM1 d o not suggest that dobutamine in this situation has significant advantages over isoprenaline, dopamine or noradrenaline. Patients in shock accompanying myocardial infarction also fail to improve with dobutamine infusions (9). However, dobutamine may well be of value during a limited period in pdtients with forward failure due to other conditions than ischemia, i.e.…”

Section: Resultsmentioning

confidence: 99%

Dobutamine in Left Heart Failure after Acute Myocardial Infarction

Rehnqvist¹,

Lundman²

1979

Journal of Internal Medicine

View full text Add to dashboard Cite

Dobutamine, a new positive inotropic drug, was given as i.v. infusion at a rate of 2.5–7.5 μg/kg/min to nine male patients with a moderately severe left heart failure. The patients were treated in our CCU for acute myocardial infarction (AMI) and had PEP/LVET above 0.40 on routine registrations of systolic time intervals, PEP (preejection phase), PEPI (PEP corrected for heart rate), LVET (left ventricular ejection time) and LVETI (LVET corrected for heart rate). Dobutamine increased contractility, measured as shortening of PEP and PEPI, and also increased ejection fraction, measured as PEP/LVET. Concomitantly, heart rate increased significantly but no changes were noted in systolic or diastolic BPs. The positive inotropic effect of dobutamine was thus accompanied by a positive chronotropic effect, which limits the usefulness of the drug in patients with recent AMI.

show abstract

“…In addition, patient safety may be enhanced by increasing the use of beta-blockers in high-risk patients and perioperative treatment with beta-blockers is now widely advocated [ 33 ]. Up to now, the hemodynamic effect of beta-blocking agents on dobutamine infusion has been controversial [ 34 , 35 ]. In addition, the best fluid replacement therapy, either restrictive or liberal in association with an inotrope, must be the subject of future studies.…”

Section: Discussionmentioning

confidence: 99%

Prospective, randomized trial comparing fluids and dobutamine optimization of oxygen delivery in high-risk surgical patients [ISRCTN42445141]

Lobo

Polachini

et al. 2006

Crit Care

View full text Add to dashboard Cite

Introduction Preventing perioperative tissue oxygen debt contributes to a better postoperative recovery. Whether the beneficial effects of fluids and inotropes during optimization of the oxygen delivery index (DO 2 I) in high-risk patients submitted to major surgeries are due to fluids, to inotropes, or to the combination of the two is not known. We aimed to investigate the effect of DO 2 I optimization with fluids or with fluids and dobutamine on the 60-day hospital mortality and incidence of complications.

show abstract

The use of dobutamine in myocardial infarction for reversal of the cardiodepressive effect of metoprolol.

Cited by 18 publications

References 18 publications

Haemodynamic effects of a new beta 1-receptor agonist in acute myocardial infarction. A useful antidote to unwanted cardiac effects of beta-blocking agents.

Haemodynamic effects of a new beta 1-receptor agonist in acute myocardial infarction. A useful antidote to unwanted cardiac effects of beta-blocking agents.

Dobutamine in Left Heart Failure after Acute Myocardial Infarction

Prospective, randomized trial comparing fluids and dobutamine optimization of oxygen delivery in high-risk surgical patients [ISRCTN42445141]

Contact Info

Product

Resources

About