Document Detail

Effects of intravenous dobutamine on coronary vasomotion in humans.
MedLine Citation:
PMID:  14607445     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to investigate the vascular mechanisms of dobutamine-induced myocardial ischemia. BACKGROUND: Dobutamine stress is often used as a surrogate for exercise. The effects of dobutamine on the epicardial arteries are incompletely understood and possibly different from those of physical exercise. METHODS: Intravenous (IV) dobutamine (40 microg/kg per min) was administered in 19 patients with normal, 23 patients with mildly atherosclerotic, and 12 patients with stenotic coronary arteries. In another two groups of patients with stenotic arteries, IV dobutamine was preceded by 1) an intracoronary (IC) bolus of the alpha-adrenergic blocker phentolamine (12 microg/kg, n = 12); and 2) an IC infusion of the nitric oxide substrate L-arginine (150 micromol/l per min for 20 min, n = 11). Intravenous saline instead of dobutamine was infused into eight patients with normal arteries. After dobutamine (or saline), an IC bolus of isosorbide dinitrate (ISDN, 0.2 mg) was given. Coronary vasomotion was evaluated by quantitative coronary angiography on angiograms obtained after each dose of dobutamine, saline, phentolamine, L-arginine, and ISDN. RESULTS: Dobutamine increased the rate-pressure product and heart rate similarly in all patients except those who received saline. Dobutamine induced vasodilation in normal (change in luminal diameter [DeltaLD] vs. baseline: 19 +/- 2%) and in mildly atherosclerotic arteries (DeltaLD: 8 +/- 2%, p < 0.05 vs. normal). In stenotic arteries, dobutamine did not induce significant vasomotion (DeltaLD: -3 +/- 3%); the latter was improved by L-arginine (DeltaLD: 10 +/- 3%, p < 0.05 vs. stenotic arteries) and fully restored by phentolamine (DeltaLD: 19 +/- 3%, p < 0.05 vs. stenotic arteries). CONCLUSIONS: Endothelial dysfunction and enhanced alpha-adrenergic tone contribute to the loss of dobutamine-induced vasodilation in coronary atherosclerosis. In contrast to physical exercise, dobutamine does not induce "paradoxical vasoconstriction" of atherosclerotic coronary arteries.
Emanuele Barbato; Jozef Bartunek; Eric Wyffels; William Wijns; Guy R Heyndrickx; Bernard De Bruyne
Related Documents :
10805415 - Passive smoking impairs endothelium-dependent relaxation of isolated rabbit arteries.
8239805 - Different vascular reactivity of human internal mammary and inferior epigastric arterie...
1828305 - Effects of calcitonin gene-related peptide (cgrp) on regional haemodynamics and on sele...
9709915 - Direct effects of thyroid hormones on rat coronary artery: nongenomic effects of triiod...
1824815 - Lipoprotein(a) in diet-induced atherosclerosis in nonhuman primates.
20652995 - Association of three different congenital malformations in a same pulmonary lobe in a 5...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  42     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-10     Completed Date:  2003-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1596-601     Citation Subset:  AIM; IM    
Cardiovascular Center, OLV Ziekenhuis, Aalst, Belgium.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Adrenergic beta-Agonists / pharmacology*
Arteriosclerosis / physiopathology
Coronary Stenosis / physiopathology
Coronary Vessels / drug effects,  physiology*
Dobutamine / pharmacology*
Dose-Response Relationship, Drug
Endothelium, Vascular / physiology
Hemodynamics / drug effects
Receptors, Adrenergic, alpha / physiology
Vasodilation / drug effects*
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Receptors, Adrenergic, alpha; 34368-04-2/Dobutamine
Comment In:
J Am Coll Cardiol. 2003 Nov 5;42(9):1602-4   [PMID:  14607446 ]

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

Previous Document:  Proton magnetic resonance spectroscopy can detect creatine depletion associated with the progression...
Next Document:  Peripheral sympathetic control during dobutamine infusion: effects of aging and heart failure.