Strum, DP and Pinsky, MR
(2002)
Does dobutamine improve ventricular function in dogs with regional myocardial dysfunction?
Anesthesia and Analgesia, 95 (1).
19 - 25.
ISSN 0003-2999
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Abstract
We studied the effect of systemic dobutamine infusion (4μg·kg-1·min-1 IV) on regional wall motion abnormalities (RWMAs) in eight anesthetized open-chested dogs. We hypothesized that infusion of small doses of dobutamine would reduce RWMAs and improve global ventricular function. Apical RWMAs were induced by local intracoronary boluses of 9.0 mg esmolol. Phase angles, effective stroke volume (SV), maximum SV, stroke work, and segmental shortening were compared among four left ventricular (LV) regions (apical, papillary, chordal, and basal) during baseline, dobutamine, esmolol, and dobutamine-esmolol treatments. The minimal global LV volume was designated as 0°, and the cardiac cycle was divided into 360 intervals. Regional phase angles were defined as the distance (in degrees) that regional minimum volume differed from global minimal LV volume (end-systole). RWMA decreased blood pressure (92 ± 2 mm Hg to 84 ± 3 mm Hg) and increased LV end-diastolic pressure (1.8 ± 0.5 mm Hg to 4.2 ± 0.8 mm Hg). RWMA delayed regional contraction (-2.9° ± 1.6° to 52.3° ± 1.5°) and decreased effective SV (2.3 ± 0.4 mL to 1.6 ± 0.3 mL) in the affected apical region but did not decrease maximal SV. Systemic infusion of dobutamine restored global LV function but failed to eliminate RWMA, as evidenced by decreased apical synchrony, effective SV, and stroke work. We concluded that systemic dobutamine restored global LV function but failed to correct RWMA.
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