Beneficial effects of prolonged low dose dopamine in hospitalized patients with severe refractory heart failure

In 10 hospitalized patients with severe congestive heart failure refractory to standard medical therapy for three days, low dose intravenous dopamine (2-4 micrograms/kg/min) was infused for 48 h. Heart rate and systolic blood pressure were unchanged throughout the study. Mean pulmonary artery wedge pressure decreased significantly during the dopamine infusion from 27 +/- 6 (SD) to 18 +/- 6 mmHg (p less than 0.01) and cardiac output increased from 3.2 +/- 1.1 to 4.6 +/- 0.8 l/min (p less than 0.001). A diuresis was initiated in all patients and there was a significant weight loss during the study which averaged 5 lbs (p less than 0.01). All patients improved symptomatically from class IV (NYHA) to class III and were more responsive to conventional therapy after the study. No adverse reactions were noted in this dose range. We conclude that low dose intravenous dopamine is efficacious in improving hemodynamics and initiating a diuresis in patients with severe refractory congestive heart failure.