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Published on: February 10, 2013

The effects of dobutamine on cardiac sympathetic activity in patients with congestive heart failure

Abdul Al-Hesayen1, Eduardo R Azevedo, Gary E Newton

  • 1Division of Cardiology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Ontario, Canada.

Journal of the American College of Cardiology
|April 17, 2002
PubMed

Insights

Dobutamine infusion reduced cardiac sympathetic activity in patients with congestive heart failure (CHF), indicating a sympatholytic effect. This finding suggests potential benefits of dobutamine in managing CHF by decreasing sympathetic drive.

Area of Science:

  • Cardiology
  • Pharmacology
  • Physiology

Background:

  • Increased cardiac sympathetic activity is linked to adverse outcomes in congestive heart failure (CHF).
  • Dobutamine, a common CHF therapy, may potentially elevate cardiac sympathetic activity due to beta-receptor stimulation.

Purpose of the Study:

  • To investigate the impact of short-term dobutamine infusion on efferent cardiac sympathetic activity.
  • To compare these effects in patients with normal left ventricular (LV) function versus those with CHF.

Main Methods:

  • Cardiac norepinephrine spillover (CANESP) was measured using a radiotracer technique.
  • Dobutamine infusion was administered intravenously and titrated to increase LV peak positive pressure (+dP/dt) by 40% in 7 normal LV function patients and 13 CHF patients.

Main Results:

  • Dobutamine increased pulse pressure in normal LV function but not in CHF patients.
  • LV end-diastolic pressure decreased significantly in CHF patients.
  • CANESP remained unchanged in normal LV function but significantly decreased in CHF patients, indicating a sympatholytic effect.

Conclusions:

  • Dobutamine infusion elicits a significant sympatholytic response in patients with CHF.
  • This sympathetic withdrawal may be attributed to reduced LV filling pressures and/or activation of ventricular mechanoreceptors.
Abstract

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