[Treatment of chronic heart insufficiency with dobutamine. Value and limitations]

Most positively inotropic drugs are available only as intravenous injection, which restricts their use in chronic heart failure. A single and brief infusion of dobutamine--a synthetic catecholamine and potent beta 1-adrenoreceptor agonist--provides a clinical improvement which may last for several weeks. On the other hand, tachyphylaxis to dobutamine may develop after a several days' infusion, so that the drug gradually loses its effectiveness. In patients with chronic heart failure, intermittent infusions of dobutamine result in sustained clinical improvement in more than 50 percent of the cases. The relative preservation of beta-adrenoceptors seems to play a role in the beneficial effects of intermittent infusions. The most significant side-effects of dobutamine are ventricular rhythm disorders. The practical applications and supervision of repeated dobutamine infusions in chronic heart failure are detailed.