Dobutamine therapy in acute myocardial infarction
E. C. Keung, S. J. Siskind, E. H. Sonneblick, H. S. Ribner, W. J. Schwartz and T. H. LeJemtel
The short-term response of combined dopamine hydrochloride-sodium
nitroprusside therapy was compared with administration of dobutamine in
eight patients with acute myocardial infarction complicated by hypotension
and severe left ventricular dysfunction. All patients were receiving
dopamine before the study began. The addition of sodium nitroprusside
increased cardiac index (Cl) from 1.94 +/- 0.490 to 2.22 +/- 0.48 L/min/sq
m; decreased left ventricular filling pressure (LVFP) from 28.9 +/- 3.5 to
19.9 +/- 3.3 mm Hg and mean systemic arterial pressure (MAP) from 82.1 +/-
5.1 to 71.5 +/- 6.0 mm Hg. During dobutamine infusion, Cl, LVFP, and MAP
were 2.33 +/- 0.31 L/min/sq m, 20.8 +/- 4.8 mm Hg, and 74.1 +/- 8.1 mm Hg,
respectively. There was no statistical difference between short-term
hemodynamic benefits produced by dobutamine or combined dopamine-sodium
nitroprusside therapy. Dobutamine, a synthetic cathecholamine, provides a
substitute for dopamine-sodium nitroprusside therapy in acute myocardial
infarction. Dobutamine has the advantage of being a single agent and is
therefore easier to administer.
