[Is intermittent dobutamine treatment beneficial in patients with dilated cardiomyopathy?].
OBJECTIVE
Dobutamine is a sympathomimetic drug, which can be used in patients with dilated cardiomyopathy (DCM). We investigated the effects of intermittent dobutamine use on cardiac parameters and quality of life in patients with DCM.


METHODS
Twelve patients with ischemic and idiopathic DCM, refractory to conventional therapy, have been included in the study. In addition to traditional treatment, dobutamine (1-2 micro g/kg/min infusion increasing up to 10 micro g/kg/min for 3 days) was administered, and repeated at the 1st, 2nd and 3rd months. The patients were evaluated 3 times, before and immediately after the first treatment and after the treatment on the third month, using echocardiography, exercise stress testing, ambulatory ECG, right ventricular catheterization, cardiac enzymes (creatine kinase MB isoenzyme - CK-MB, troponin-T) and the Minnesota Living with Heart Failure Questionnaire for quality of life.


RESULTS
After the first treatment, left ventricular ejection fraction (LVEF), cardiac output, cardiac index (CI), pulmonary wedge pressure and life quality improved significantly (p<0.05); but, after the treatment on the third month, these parameters except PCWP returned to nearly baseline values. Additionally, a significant increase in the number of patients with ventricular premature beats and with troponin-T positivity was detected after the third month of treatment.


CONCLUSIONS
The use of dobutamine in addition to conventional therapy in patients with DCM provided improvements in some systolic parameters and quality of life particularly after the first treatment. In the late period of the treatment, however, it was determined that these beneficial effects tended to disappear and harmful effects became more evident.
Eryol
Namik Kemal
NK
Department of Cardiology, Medical Faculty, Erciyes University, Kayseri. nkeryol@erciyes.edu.tr
Güven
Muhammed
M
Topsakal
Ramazan
R
Abaci
Adnan
A
Başar
Emrullah
E
Ergin
Ali
A
Cetin
Servet
S
D002302:Cardiac Output; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D004280:Dobutamine / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005080:Exercise Test; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure; D011788:Quality of Life; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left
D002316:Cardiotonic Agents; D004280:Dobutamine