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Related Experiment Videos

Transient dobutamine-mediated pulsus alternans.

J H Kahn1, M R Starling, M A Supiano

  • 1Department of Internal Medicine, Division of Geriatric Medicine, Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA.

The Canadian Journal of Cardiology
|February 27, 2001
PubMed
Summary
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Pulsus alternans, a condition of alternating weak and strong heartbeats, is typically seen in severe heart failure. This study shows dobutamine can cause reversible pulsus alternans even in mild heart failure.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Pharmacology

Background:

  • Pulsus alternans is characterized by alternating weak and strong heartbeats at a constant rate.
  • It is most commonly observed in patients with severe, end-stage heart failure.
  • Mildly impaired myocardial contractility can be a precursor to cardiac dysfunction.

Observation:

  • A patient with New York Heart Association functional class I heart failure was studied.
  • Pulsus alternans developed during inotropic stimulation with dobutamine.
  • The observed pulsus alternans resolved as dobutamine cleared from the system.

Findings:

  • Dobutamine, a potent inotropic agent, can precipitate pulsus alternans.
  • This phenomenon occurred in a patient with only mild heart failure.

Related Experiment Videos

  • The pulsus alternans was reversible and transient, correlating with dobutamine levels.

    • Implications:

    • Inotropic stimulation with dobutamine may unmask or induce pulsus alternans in patients with subtle myocardial dysfunction.
    • This finding expands the clinical context for pulsus alternans beyond severe heart failure.
    • Careful monitoring for pulsus alternans is warranted during dobutamine administration, even in less advanced heart failure stages.