Combined hemodynamic effects of dobutamine and IV nitroglycerin in congestive heart failure.

Abstract

The combined and separate hemodynamic effects of dobutamine and IV nitroglycerin were compared in 12 patients with chronic congestive heart failure (nine with ischemic heart disease, two with idiopathic congestive cardiomyopathy, and one with valvular heart disease). Dobutamine (7.1 micrograms/kg/min) increased cardiac index from 2.4 +/- 0.4 to 3.4 +/- 0.9 L/min/m2 (P < 0.001) and decreased pulmonary wedge pressure from 28 +/- 5 to 16 +/- 4 mm Hg (P < 0.001) while nitroglycerin (127 micrograms/min) alone increased cardia index to 2.8 L/min/m2 (P < 0.001) and decreased wedge pressure to 14.3 mm Hg (P < 0.001). With both drugs, cardiac index increased to 3.5 +/- 0.6 L/min/m2; (NS compared to dobutamine alone) wedge pressure decreased to 11 +/- 4L/min/m2 (P < 0.05 compared to dobutamine alone). Those beneficial hemodynamic effects occurred without a significant change in the double product of heart rate and blood pressure, and were associated with an improvement in the transmyocardial gradient. Thus, the greatly enhanced ventricular performance with dobutamine + nitroglycerin was associated with a better relationship between myocardial oxygen demand and supply.

• Authors: R M Gagnon, L Fortin, R Boucher, S Gilbert, M Morrisette, S Present, J Lemire, A David
• Journal: Chest (Chest) Vol. 78 Issue 5 Pg. 694-8 (Nov 1980) ISSN: 0012-3692 [Print] United States
• PMID: 6775881 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Catecholamines
• Dobutamine
• Nitroglycerin

Topics

• Adult
• Aged
• Cardiac Output (drug effects)
• Catecholamines (therapeutic use)
• Dobutamine (pharmacology, therapeutic use)
• Drug Synergism
• Heart Failure (drug therapy)
• Hemodynamics (drug effects)
• Humans
• Middle Aged
• Nitroglycerin (pharmacology, therapeutic use)
• Pulmonary Wedge Pressure (drug effects)