Haemodynamic Effects of Dobutamine in Patients with Coronary Artery Disease

1977 ◽  
Vol 5 (1) ◽  
pp. 10-17 ◽  
Author(s):  
B Magnani ◽  
E Ambrosioni ◽  
A Branzi ◽  
F Picchio ◽  
P Capitanucci
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Cardiac Output ◽  
Coronary Artery ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Haemodynamic Effects ◽  
Dose Infusion ◽  
Pulmonary Arterial ◽  
Artery Disease

The haemodynamic effects of the infusion of dobutamine in dosages of 2·5, 5·0 and 10·0 μg/kg/min were studied in twelve patients with coronary artery disease. At the lowest dose, infusion of dobutamine caused a significant increase in cardiac output; greater increases occurred with doses of 5·0 and 10·0 μg/kg/min. The means by which the myocardium produced the increase in cardiac output differed according to the dose of the drug; 2·5 and 5·0 μg/kg/min produced an increase in stroke volume without any significant variation in the heart rate. At the highest dose rate, an increase in heart rate made a distinct contribution to the overall increase in output. The ventricular dp/dt max. increased at all three dosages. Blood pressure, pulmonary arterial and capillary pressure, and left ventricular and diastolic pressure did not show any significant change. The separation of the inotropic and the chronotropic effects of dobutamine according to the infused dose appears to have extremely interesting clinical implications.

scholarly journals Impact of Renin-Angiotensin-Aldosterone System Gene Polymorphisms on Left Ventricular Dysfunction in Coronary Artery Disease Patients

2012 ◽  
Vol 32 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Avshesh Mishra ◽  
Anshika Srivastava ◽  
T. Mittal ◽  
N. Garg ◽  
B. Mittal
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Output ◽  
Coronary Artery ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
P Value ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Artery Disease

Background: Left ventricular dysfunction (LVD), followed by fall in cardiac output is one of the major complications in some coronary artery disease (CAD) patients. The decreased cardiac output over time leads to activation of the renin-angiotensin-aldosterone system which results in vasoconstriction by influencing salt-water homeostasis. Therefore, the purpose of the present study was to explore the association of single nucleotide polymorphisms (SNPs) in angiotensin I converting enzyme;ACE(rs4340), angiotensin II type1 receptor; AT1 (rs5186) and aldosterone synthase;CYP11B2(rs1799998) with LVD.Methods and results: The present study was carried out in two cohorts. The primary cohort included 308 consecutive patients with angiographically confirmed CAD and 234 healthy controls. Among CAD, 94 with compromised left ventricle ejection fraction (LVEF ≤ 45) were categorized as LVD. The ACE I/D, AT1 A1166C andCYP11B2T-344C polymorphisms were determined by PCR. Our results showed that ACE I/D was significantly associated with CAD but not with LVD. However, AT1 1166C variant was significantly associated with LVD (LVEF ≤ 45) (p value=0.013; OR=3.69), butCYP11B2(rs1799998) was not associated with either CAD or LVD. To validate our results, we performed a replication study in additional 200 cases with similar clinical characteristics and results again confirmed consistent findings (p value=0.020; OR=5.20).Conclusion: AT1 A1166C plays important role in conferring susceptibility of LVD.

E/e` ratio is superior to speckle tracking for detecting elevated left ventricular end-diastolic pressure in patients with coronary artery disease and preserved ejection fraction

2019 ◽  
Vol 36 (7) ◽  
pp. 1263-1272 ◽  
Author(s):  
Antonio Amador Calvilho Júnior ◽  
Jorge Eduardo Assef ◽  
David Le Bihan ◽  
Rodrigo Bellio de Mattos Barretto ◽  
Antonio Tito Paladino Filho ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Speckle Tracking ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Artery Disease

scholarly journals Intravenous Nitroglycerin during Surgery for Coronary Artery Disease

1981 ◽  
Vol 9 (3) ◽  
pp. 247-254 ◽  
Author(s):  
S. E. Kaye ◽  
W. Dimai ◽  
R. Gattiker
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Cardiac Index ◽  
Diastolic Pressure ◽  
High Dose ◽  
Intravenous Nitroglycerin ◽  
Coronary Artery Surgery ◽  
Artery Disease ◽  
Ischaemic Episode

Intravenous infusions of nitroglycerin decreased systemic systolic, pulmonary systolic and wedge pressures in β-blocked patients anaesthetised for coronary artery surgery with high dose of fentanyl without changing heart rate, diastolic pressure, or cardiac index, thus leading to an improvement in endocardial viability ratio. The use of a nitroglycerin bolus to abort an acute myocardial ischaemic episode is described.

scholarly journals Elevated heart rate in hypertension and coronary artery disease: risk factor or risk marker in patients with preserved left ventricular ejection fraction

2019 ◽  
Vol 25 (4) ◽  
pp. 389-406 ◽  
Author(s):  
E. V. Kokhan ◽  
G. K. Kiyakbaev ◽  
Z. D. Kobalava
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Positive Effects ◽  
Artery Disease

Numerous studies have demonstrated the negative prognostic value of tachycardia, both in the general population and in specific subgroups, including patients with coronary artery disease (CAD), arterial hypertension (HTN) and heart failure with preserved ejection fraction (HFpEF). In the latest edition of the European guidlines for the treatment of HTN the level of heart rate (HR) exceeding 80 beats per minute is highlighted as a separate independent predictor of adverse outcomes. However, the feasibility of pharmacological reduction of HR in patients with sinus rhythm is unclear. Unlike patients with reduced ejection fraction, in whom the positive effects of HR reduction are well established, the data on the effect of pharmacological HR reduction on the prognosis of patients with HTN, CAD and/or HFpEF are not so unambiguous. Some adverse effects of pharmacological correction of HR in such patients, which may be caused by a change in the aortic pressure waveform with its increase in late systole in the presence of left ventricular diastolic dysfunction, are discussed. The reviewed data underline the complexity of the problem of clinical and prognostic significance of increased HR and its correction in patients with HTN, stable CAD and/or HFpEF.

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