Miyagi Y, Sasayama S, Nakajima H, Fujita M, Asanoi H
Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
J Cardiovasc Pharmacol. 1990 Jan;15(1):138-43. doi: 10.1097/00005344-199001000-00022.
In nine patients with chronic congestive heart failure, the acute hemodynamic response to intravenous (i.v.) dibutyryl cyclic AMP (DBcyclicAMP) administration was compared with i.v. dobutamine administration. Both agents led to a significant and similar increase in cardiac index. Dobutamine caused a significant increase in mean arterial pressure but did not produce a significant change in pulmonary capillary wedge, mean pulmonary artery, or mean right atrial pressures. In contrast, DBcyclicAMP caused a significant decrease in mean arterial, mean pulmonary capillary wedge, mean pulmonary artery, and mean right atrial pressures, reflecting vasodilator activity. The fall in systemic vascular resistance was larger after DBcyclicAMP than after dobutamine. DBcyclicAMP achieves an optimal improvement in cardiovascular hemodynamics in concert with substantial vasodilating effect. This pharmacologic action constitutes the mainstay of i.v. therapy for severe congestive heart failure (CHF).
在9例慢性充血性心力衰竭患者中，比较了静脉注射二丁酰环磷腺苷（DBcyclicAMP）和静脉注射多巴酚丁胺的急性血流动力学反应。两种药物均导致心脏指数显著且相似地增加。多巴酚丁胺使平均动脉压显著升高，但肺毛细血管楔压、平均肺动脉压或平均右心房压无显著变化。相比之下，DBcyclicAMP使平均动脉压、平均肺毛细血管楔压、平均肺动脉压和平均右心房压显著降低，反映出血管舒张活性。DBcyclicAMP后全身血管阻力的下降幅度大于多巴酚丁胺后。DBcyclicAMP在产生显著血管舒张作用的同时，实现了心血管血流动力学的最佳改善。这种药理作用构成了重度充血性心力衰竭（CHF）静脉治疗的主要手段。
