Document Detail


Haemodynamic advantages of a combined inotropic/venodilator regimen over inotropic monotherapy in acute heart failure.
MedLine Citation:
PMID:  2413305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The haemodynamic influence of positive inotropic therapy with dobutamine, both alone and when combined with isosorbide dinitrate, was evaluated in 10 consecutive patients admitted to Coronary Care with acute left ventricular failure (pulmonary artery occluded pressure greater than 20 mm Hg) complicating myocardial infarction. Dobutamine increased systemic arterial blood pressure and heart rate without reduction in the left heart filling pressure; cardiac index (+0.9 L/min/m2; p less than 0.01) was substantially increased. Thus, consequent on these effects, dobutamine could increase myocardial oxygen requirements. The addition of intravenous isosorbide dinitrate reduced systemic arterial pressure and left heart filling pressure; the augmented cardiac index following therapy with dobutamine alone was maintained. Combined dobutamine/nitrate therapy, therefore, appeared haemodynamically superior to dobutamine monotherapy, in that it improved cardiac stroke volume at a normalised left ventricular filling pressure. These data suggest that combined dobutamine/nitrate therapy may prove useful as an adjunct to the treatment of normotensive heart failure complicating acute myocardial infarction.
Authors:
S P Verma; B Silke; G I Nelson; M Hussain; A Richmond; S H Taylor
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  7     ISSN:  0160-2446     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:    1985 Sep-Oct
Date Detail:
Created Date:  1985-11-21     Completed Date:  1985-11-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  943-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiotonic Agents / therapeutic use*
Dobutamine / therapeutic use
Drug Therapy, Combination
Heart Failure / drug therapy*,  physiopathology
Hemodynamics / drug effects*
Humans
Isosorbide Dinitrate / therapeutic use
Male
Middle Aged
Myocardial Contraction / drug effects
Oxygen Consumption / drug effects
Pulmonary Circulation / drug effects
Vasodilator Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Vasodilator Agents; 34368-04-2/Dobutamine; 87-33-2/Isosorbide Dinitrate

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


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