Strum David P, Pinsky Michael R
Department of Anesthesiology and Critical Care Medicine, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada.
Anesth Analg. 2002 Jul;95(1):19-25, table of contents. doi: 10.1097/00000539-200207000-00003.
We studied the effect of systemic dobutamine infusion (4 microg. kg(-1). min(-1) IV) on regional wall motion abnormalities (RWMAs) in eight anesthetized open-chested dogs. We hypothesized that infusion of small doses of dobutamine would reduce RWMAs and improve global ventricular function. Apical RWMAs were induced by local intracoronary boluses of 9.0 mg esmolol. Phase angles, effective stroke volume (SV), maximum SV, stroke work, and segmental shortening were compared among four left ventricular (LV) regions (apical, papillary, chordal, and basal) during baseline, dobutamine, esmolol, and dobutamine-esmolol treatments. The minimal global LV volume was designated as 0 degrees, and the cardiac cycle was divided into 360 intervals. Regional phase angles were defined as the distance (in degrees) that regional minimum volume differed from global minimal LV volume (end-systole). RWMA decreased blood pressure (92 +/- 2 mm Hg to 84 +/- 3 mm Hg) and increased LV end-diastolic pressure (1.8 +/- 0.5 mm Hg to 4.2 +/- 0.8 mm Hg). RWMA delayed regional contraction (-2.9 degrees +/- 1.6 degrees to 52.3 degrees +/- 1.5 degrees ) and decreased effective SV (2.3 +/- 0.4 mL to 1.6 +/- 0.3 mL) in the affected apical region but did not decrease maximal SV. Systemic infusion of dobutamine restored global LV function but failed to eliminate RWMA, as evidenced by decreased apical synchrony, effective SV, and stroke work. We concluded that systemic dobutamine restored global LV function but failed to correct RWMA.
We examined the effect of systemic dobutamine on regional wall motion abnormalities (RWMAs) induced by intracoronary esmolol infusion in eight anesthetized dogs. Esmolol dilated the heart and decreased regional synchrony of contraction. Dobutamine restored cardiac function but failed to correct the asynchrony of regional contraction caused by esmolol-induced RWMAs.
我们研究了静脉输注多巴酚丁胺（4微克·千克⁻¹·分钟⁻¹）对8只麻醉开胸犬局部室壁运动异常（RWMA）的影响。我们假设输注小剂量多巴酚丁胺会减少RWMA并改善整体心室功能。通过局部冠状动脉推注9.0毫克艾司洛尔诱导心尖部RWMA。在基线、多巴酚丁胺、艾司洛尔以及多巴酚丁胺 - 艾司洛尔治疗期间，比较了四个左心室（LV）区域（心尖、乳头肌、腱索和基底）的相位角、有效每搏输出量（SV）、最大SV、每搏功和节段缩短情况。将左心室最小整体容积指定为0度，心动周期分为360个间期。局部相位角定义为局部最小容积与左心室最小整体容积（收缩末期）的差值（以度为单位）。RWMA使血压降低（从92±2毫米汞柱降至84±3毫米汞柱），并使左心室舒张末期压力升高（从1.8±0.5毫米汞柱升至4.2±0.8毫米汞柱）。RWMA使受影响的心尖区域局部收缩延迟（从 - 2.9度±1.6度变为52.3度±1.5度），有效SV降低（从2.3±0.4毫升降至1.6±0.3毫升），但未降低最大SV。多巴酚丁胺全身输注恢复了左心室整体功能，但未能消除RWMA，表现为心尖同步性降低、有效SV和每搏功下降。我们得出结论，多巴酚丁胺全身输注恢复了左心室整体功能，但未能纠正RWMA。
我们研究了全身输注多巴酚丁胺对8只麻醉犬冠状动脉内输注艾司洛尔诱导的局部室壁运动异常（RWMA）的影响。艾司洛尔使心脏扩张并降低局部收缩同步性。多巴酚丁胺恢复了心脏功能，但未能纠正由艾司洛尔诱导的RWMA所导致的局部收缩不同步。
