Document Detail


Effect of low-dose positive inotropic drugs on human internal mammary artery flow.
MedLine Citation:
PMID:  9436565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dobutamine (a beta-receptor agonist), enoximone (a type III selective phosphodiesterase inhibitor), and epinephrine (an alpha- and beta-mimetic) frequently are used in the perioperative management of patients undergoing coronary artery bypass grafting. METHODS: We performed a double-blind clinical study to compare the effects on internal mammary artery free flow of low doses of these three positive inotropic drugs. Thirty patients in whom the left internal mammary artery was used for coronary artery bypass grafting were randomized into three groups. Internal mammary artery free flow and hemodynamic measurements were evaluated before and 10 minutes after the intravenous infusion of dobutamine (3 microg x kg(-1) x min(-1)), enoximone (200 microg/kg), or epinephrine (0.05 microg x kg(-1) x min(-1)). RESULTS: A significant increase in free flow occurred only in the dobutamine group (33 +/- 7.5 and 42.2 +/- 7.9 mL/min before and after drug infusion, respectively; p = 0.013). Comparison of the increase in flow between the groups, however, showed no difference. These drugs, at doses designed to produce a positive inotropic effect, caused little increase in the free flow of the internal mammary artery. CONCLUSIONS: The use of dobutamine, enoximone, and epinephrine as low-dose positive inotropic treatments in the perioperative and postoperative periods of coronary artery bypass grafting should depend on their positive inotropic effects rather than their vasodilative effects on the arterial grafts.
Authors:
J L Cracowski; O Chavanon; M Durand; E Borrel; P Devillier; J M Mallion; D Blin
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  64     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-02-10     Completed Date:  1998-02-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1742-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, Grenoble University Hospital, France.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / administration & dosage
Adult
Aged
Cardiotonic Agents / administration & dosage*
Coronary Artery Bypass*
Coronary Circulation / drug effects
Dobutamine / administration & dosage
Double-Blind Method
Enoximone / administration & dosage
Epinephrine / administration & dosage
Female
Hemodynamics / drug effects
Humans
Infusions, Intravenous
Male
Mammary Arteries
Middle Aged
Phosphodiesterase Inhibitors / administration & dosage
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Cardiotonic Agents; 0/Phosphodiesterase Inhibitors; 34368-04-2/Dobutamine; 51-43-4/Epinephrine; 77671-31-9/Enoximone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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