© 2004 European Society of Cardiology
Catecholamines restore myocardial contractility in dilated cardiomyopathy at the expense of increased coronary blood flow and myocardial oxygen consumption (MvO2 cost of catecholamines in heart failure)
a Department of Medicine, Allegheny General Hospital, Drexel University College of Medicine 320 E. North Avenue, Pittsburgh, PA 15212, USA
b Cardiovascular Surgery, Allegheny General Hospital, Drexel University College of Medicine Pittsburgh, PA, USA
c Department of Medicine, University of Pittsburgh Medical Center Pittsburgh, PA, USA
d Merck Research Laboratories, University of Pittsburgh Medical Center West Point, PA, USA
* Corresponding author. Tel.: +1-412-359-3022; fax: +1-412-359-8152. E-mail address: rshannon{at}wpahs.org
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Abstract |
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To investigate the metabolic cost of catecholamine use in heart failure, we administered intravenous dobutamine or norepinephrine to dogs with moderate and severe LV dysfunction until LV contractile function was restored to normal levels. Both drugs were associated with significant increases in myocardial O2 consumption, increased coronary blood flow requirements and decreased myocardial mechanical efficiency. These mechanisms may contribute to the deleterious effects of catecholamines in heart failure.
Key Words: CHF, Congestive heart failure • CO, Cardiac output • SV, Stroke volume • CBF, Coronary blood flow • MvO2, Myocardial O2 consumption • MAP, Mean arterial pressure • HR, Heart rate • LVEDP, Left ventricular end-diastolic pressure • LV dP/dt, first derivative of LV pressure • LVEDD, Left ventricular end diastolic diameter • LVESD, Left ventricular end systolic diameter
Received June 3, 2003; Accepted September 15, 2003