| Redistribution of myocardial blood flow distal to a dynamic coronary arterial stenosis by sympathomimetic amines: comparison of dopamine, dobutamine and isoproterenol. | |
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MedLine Citation:
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PMID: 7270436 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effects of dopamine, dobutamine and isoproterenol on coronary hemodynamics, severity of stenosis, distal bed resistance and transmural myocardial perfusion gradients with radioactive microspheres were studied in dogs with a mild obstruction of the left circumflex coronary artery anesthetized with morphine-chloralose. Changes in transmural blood flow were related to the ratio of the diastolic aortic pressure-time index to tension-time index (DPTI/TTI) and the ratio of the distal diastolic coronary pressure-time index to tension-time index (DDPTI/TTI). At doses of 5 microgram/kg per min, dopamine had no significant effect on DPTI/TTI, DDPTI/TTI or endocardial/epicardial flow ratio; however, dobutamine produced a slight decrease in this flow ratio and in DDPTI/TTI. At doses of 10 microgram/kg per min, both drugs produced a significant (p less than 0.05) reduction in diastolic coronary pressure distal to the stenosis. DDPTI/TTI and endocardial/epicardial flow ratio without change in DPTI/TTI. In comparison, isoproterenol (0.01 and 0.05 microgram/kg per min) produced dose-related decreases in endocardial/epicardial flow ratio, DDPTI/TTI and DPTI/TTI. During infusion of each sympathomimetic agent, there was a corresponding reduction in distal bed vascular resistance but a concomitant increase in stenosis resistance. The results also show that dopamine and dobutamine, as well as isoproterenol, area capable of producing a maldistribution of coronary blood flow distal to a mild coronary arterial stenosis and that such a redistribution of glow is dependent on dose, reduction of the distal diastolic coronary pressure-time index and decrease in DDPTI/TTI. It is further concluded that hemodynamic changes distal to a coronary arterial stenosis seriously jeopardize the usefulness of DPTI/TTI; however, DDPTI/TTI can be used to predict drug effects on the endocardial/epicardial flow ratio in an ischemic area. This study demonstrates that "fixed" stenoses can undergo dynamic processes and sympathomimetic amines increase the resistance to flow through a stenotic coronary artery in the nonfailing heart. |
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Authors:
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D C Warltier; M Zyvoloski; G J Gross; H F Hardman; H L Brooks |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The American journal of cardiology Volume: 48 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1981 Aug |
Date Detail:
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Created Date: 1981-10-25 Completed Date: 1981-10-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 269-79 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Catecholamines / pharmacology* Coronary Circulation / drug effects* Coronary Disease / physiopathology* Coronary Vessels / physiopathology Diastole / drug effects Dobutamine / pharmacology* Dogs Dopamine / pharmacology* Hemodynamics / drug effects Isoproterenol / pharmacology* Models, Biological Time Factors Vascular Resistance / drug effects |
| Grant Support | |
ID/Acronym/Agency:
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HL 25120/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Catecholamines; 34368-04-2/Dobutamine; 7683-59-2/Isoproterenol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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