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Low-dose inotropic stimulation during left ventricular ischaemia does not worsen post-ischaemic dysfunction
G G Schwartz1, Y Xu, C Greyson
1Cardiology Section, Department of Veterans Affairs Medical Center, San Francisco, CA 94121, USA.
Cardiovascular Research
|December 1, 1996
Summary
Low-dose dobutamine during left ventricular (LV) ischemia improved aerobic metabolism without worsening post-ischemic dysfunction. This study found inotropic stimulation did not exacerbate LV dysfunction after ischemia.
Area of Science:
- Cardiology
- Physiology
- Experimental Medicine
Background:
- Inotropic agents are clinically used to enhance ventricular function during ischemic events.
- The potential impact of inotropic stimulation on post-ischemic left ventricular (LV) dysfunction requires further investigation.
Purpose of the Study:
- To determine if inotropic stimulation during moderate LV ischemia exacerbates post-ischemic LV dysfunction.
- To assess the effects of dobutamine on aerobic and anaerobic metabolism during ischemia.
Main Methods:
- 18 open-chest anesthetized pigs underwent induced regional LV ischemia.
- Regional preload-recruitable stroke work (PRSW) and LV end-diastolic pressure (EDP) relations were analyzed.
- Dobutamine was administered to one group during ischemia; a control group received no stimulation.
Main Results:
- Dobutamine increased heart rate, blood pressure, subendocardial blood flow, oxygen consumption, and PRSW in the ischemic zone.
- Lactate release was not affected by dobutamine.
- Post-reperfusion, PRSW was similarly reduced in both groups, indicating no worsening of dysfunction.
Conclusions:
- Low-dose inotropic stimulation during moderate regional LV ischemia enhances aerobic metabolism.
- Dobutamine did not worsen post-ischemic LV dysfunction.
- The study suggests inotropic support can be safely used in specific ischemic scenarios.