Beneficial effects of dopamine combined with intravenous nitroglycerin on hemodynamics in patients with severe left ventricular failure

Circulation
H S LoebR M Gunnar

Abstract

Hemodynamic effects of dopamine and intravenous nitroglycerin alone, and in combination, were studied in 27 patients with severe left ventricular failure. Dopamine alone increased cardiac index from 1.8 to 2.5 l/min/m2 but also increased wedge pressure from 24 to 30 mm Hg and heart rate from 88 to 101 beats/min. Arterial oxygen saturation fell from 92% to 87% (p less than .001). Nitroglycerin alone had a lesser effect on cardiac index (1.8 to 2.2 l/min/m2) but decreased wedge pressure from 26 to 16 mm Hg and heart rate from 91 to 86 beats/min. Arterial oxygen saturation fell from 91% to 90% (NS). Combined dopamine and nitroglycerin administration resulted in optimal hemodynamics, with cardiac index of 2.9 l/min/m2, wedge pressure of 17 mm Hg, and heart rate of 96 beats/min. Arterial oxygen saturation remained low at 88% in spite of the reduction in left ventricular filling pressure, which probably reflects increased intrapulmonary right-to-left shunting coupled with increased pulmonary blood flow. These results suggest that the combination of dopamine with intravenous nitroglycerin should be considered for patients with severe left ventricular dysfunction who require temporary pharmacologic support.

References

Jul 1, 1978·The American Journal of Medicine·J N Cohn, J A Franciosa
Oct 1, 1976·The American Journal of Cardiology·W R TaylorH J Swan
Feb 6, 1975·The New England Journal of Medicine·R F Palmer, K C Lasseter
Feb 1, 1970·The Journal of Clinical Investigation·A L MarkJ W Eckstein
Oct 3, 1974·The New England Journal of Medicine·L I Goldberg
Aug 1, 1971·Circulation·H S LoebR M Gunnar
Jun 11, 1972·The American Journal of Physiology·F R CobbJ C Greenfield
May 1, 1983·Annals of Internal Medicine·R GinsburgM R Bristow

❮ Previous
Next ❯

Citations

Jun 1, 1994·Cardiovascular Drugs and Therapy·J Dupuis
Jan 13, 2001·Seminars in Thoracic and Cardiovascular Surgery·J H GormanM A Acker
Mar 1, 1986·Journal of Clinical Pharmacology·S C Balderman, J Aldridge
Sep 1, 1987·Journal of Cardiac Surgery·V J DiSesa
Jan 1, 1985·Acta Medica Scandinavica. Supplementum·J Heikkilä

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.