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Dopamine: its potential for inducing ischemic left ventricular dysfunction.

G Wisenberg, A G Zawadowski, V A Gebhardt

    Journal of the American College of Cardiology
    |July 1, 1985
    PubMed
    Summary
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    Dopamine infusion alone did not adequately stress patients with coronary artery disease. Adding atropine to dopamine pharmacologic stress testing improved heart rate response, making it comparable to exercise stress testing.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Nuclear Medicine

    Background:

    • Coronary artery disease (CAD) necessitates reliable stress testing for diagnosis and management.
    • Pharmacologic stress agents are crucial for patients unable to exercise.
    • Dopamine's potential as a pharmacologic stress agent, despite risks of ischemia, was investigated.

    Purpose of the Study:

    • To evaluate intravenous dopamine as a pharmacologic stress agent in supine radionuclide angiography.
    • To compare dopamine's efficacy against standard ergometer exercise stress testing.
    • To assess the impact of adding atropine to dopamine stress protocols.

    Main Methods:

    • Initial phase: Dopamine infusion (2.5-15 µg/kg/min) in 11 subjects (4 normal, 7 CAD).
    • Second phase: Dopamine with atropine (0.6 mg) in 41 subjects (9 normal, 32 CAD).

    Related Experiment Videos

  • Supine radionuclide angiography used to assess cardiac function (ejection fraction) and hemodynamic responses.

    • Main Results:

    • Dopamine alone induced significantly lower maximal heart rates and rate-pressure products compared to exercise in both normal and CAD subjects.
    • Ejection fraction response differed significantly between exercise (-3.3%) and dopamine (+6.3%) in CAD patients.
    • Dopamine combined with atropine achieved statistically similar maximal heart rates to exercise in all subjects and comparable rate-pressure products in normal subjects.

    Conclusions:

    • Intravenous dopamine alone is insufficient as a pharmacologic stress agent for radionuclide angiography in CAD patients.
    • The addition of atropine to dopamine significantly enhances the pharmacologic stress response, yielding results comparable to exercise stress.
    • Dopamine-atropine combination represents a potentially viable alternative for pharmacologic stress testing in patients with coronary artery disease.