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Edmund C. H. Keung, MD; Steven J. Siskind, MD; Edmund H. Sonneblick, MD; Hillel S. Ribner, MD; William J. Schwartz, MD; Thierry H. LeJemtel, MD

JAMA. 1981;245(2):144-146.

Abstract
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 (CI) from 1.94±0.49 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, CI, 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 catecholamine, 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.

(JAMA 1981;245:144-146)

Author Affiliations
From the Division of Cardiology, the Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.

Footnotes
Reprint requests to Albert Einstein College of Medicine, Division of Cardiology, 1300 Morris Park Ave, Forchheimer Bldg, Room 715, Bronx, NY 10461 (Dr LeJemtel).

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