Beneficial haemodynamic effects of intravenous dopexamine in patients with low-output heart failure.
Dopexamine is a novel compound that has DA1-dopaminergic and beta 2-adrenergic agonist properties capable of producing beneficial systemic and renal vasodilation. The acute haemodynamic effects in 10 patients with low-output-state ischaemic cardiac failure (NYHA IV) were recorded before (control) and during graded incremental doses of dopexamine infusion from 0.5 to 6.0 micrograms/kg/min. Dopexamine produced a marked increase in cardiac index from 1.6 +/- 0.2 (control) to a maximum of 2.8 +/- 0.4 L/min/m2 (p less than 0.001) primarily by inducing vasodilation, with reduction in systemic vascular resistance from 1,720 +/- 136 (control) to 1,116 +/- 136 dynes.s.cm-5 (p less than 0.05). Using a more sophisticated analytical technique which enables us to separate direct inotropic from vasodilatory effects, we were able to identify, in eight of the patients, a direct dopexamine-induced positive inotropism. These beneficial central haemodynamic effects of dopexamine, when coupled with its known DA1-dopaminergic agonist property, indicate that dopexamine may have a place in the management of patients in severe heart failure.
D000318:Adrenergic beta-Agonists / Q000494:pharmacology; D000368:Aged; D002303:Cardiac Output, Low / Q000503:physiopathology*; D004298:Dopamine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D009638:Norepinephrine / Q000378:metabolism
D000318:Adrenergic beta-Agonists; C046318:dopexamine; D004298:Dopamine; D009638:Norepinephrine