[Tolerance development during a 1-week course of dobutamine treatment].
Eleven patients with chronic heart failure (NYHA stage III or IV) were given dobutamine infusions over 7 days, mean dose 6.2 +/- 2.2 micrograms/kg X min. The patients were pretreated with digitalis, diuretics, and vasodilators. Haemodynamic parameters were measured prior to infusion, 30 minutes and 7 days thereafter as well as 24 hours after the end of therapy. Before and after the 7-day therapy a two-dimensional echocardiogram was taken. In four patients, the protocol had to be discontinued prematurely for technical or medical reasons.


RESULTS
Arterial blood pressure, body weight, fractional shortening and end-diastolic diameter of the left ventricle were not changed significantly. Cardiac index rose acutely and returned to initial values after 7 days. Total peripheral resistance, which was initially significantly reduced, again rose after infusion over 7 days. Permanent reduction in pulmonary artery wedge pressure, even one day after the end of therapy, was observed in three patients showing a left-ventricular end-diastolic wall thickness greater than 7 mm. However, in patients whose wall thickness was less than 7 mm, there was a rise in pulmonary artery wedge pressure accompanied by a fall in cardiac index even below initial values.
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D004280:Dobutamine / Q000378:metabolism / Q000627:therapeutic use*; D004361:Drug Tolerance; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D013268:Stimulation, Chemical; D014882:Water-Electrolyte Balance / Q000187:drug effects
D004280:Dobutamine
Toleranzentwicklung während einwöchiger Dobutamin-Behandlung.