Katoh T, Mori F, Miyamoto M, Esato K
First Department of Surgery, Yamaguchi University School of Medicine, Japan.
Jpn J Surg. 1990 Jul;20(4):429-36. doi: 10.1007/BF02470827.
In order to investigate whether dopamine combined with bunazosin improves cardiac function, the global and regional cardiac function and regional blood flow of 7 anesthetized dogs were analyzed before and after occlusion of the left anterior descending coronary artery (LAD), then after 10 micrograms/kg/min dopamine infusion following the LAD occlusion, and again after a bolus infusion of bunazosin 250 micrograms/kg. Dopamine with bunazosin reduced left atrial pressure from 4.9 +/- 0.9 to 3.1 +/- 0.5 mmHg (p less than 0.05) and improved cardiac output from 1.22 +/- 0.15 to 1.50 +/- 0.14 L/min (p less than 0.05), maximum positive left ventricular dp/dt from 1721 +/- 202 to 3600 +/- 663 mmHg/sec (p less than 0.05) and the time constant from 45.2 +/- 5.0 to 27.5 +/- 4.6 msec (p less than 0.01). Bunazosin added to the dopamine reduced the elevated left ventricular peak systolic pressure caused by dopamine from 130 +/- 7 to 113 +/- 8 mmHg (p less than 0.01). With regard to the regional wall motion, the impaired LAD-delta L (the segment systolic shortening) and LAD-Elmax (the slope of peak systolic pressure--endsystolic length relation) following the LAD occlusion improved from 0.5 +/- 2.5 per cent to 5.9 +/- 2.6 per cent (p less than 0.01) and from 50 +/- 9 to 82 +/- 14 mmHg/mm (p less than 0.01) after the infusion of dopamine with bunazosin. Dopamine greatly increased the Rate Pressure Product (RPP) from 12610 +/- 1120 after LAD occlusion to 16950 +/- 1420, whereas dopamine in combination with bunazosin did not increase the RPP due to a drop of LV-PSP with little change in regional myocardial blood flow. It was concluded that combining dopamine with bunazosin was useful for improving both the global and regional cardiac functions of the ischemic heart.
为了研究多巴胺联合布那唑嗪是否能改善心脏功能,对7只麻醉犬在左冠状动脉前降支(LAD)闭塞前后、LAD闭塞后以10微克/千克/分钟的速度输注多巴胺后以及推注250微克/千克布那唑嗪后,分析其整体和局部心脏功能及局部血流情况。多巴胺与布那唑嗪联合使用使左心房压力从4.9±0.9降至3.1±0.5 mmHg(p<0.05),心输出量从1.22±0.15升/分钟提高到1.50±0.14升/分钟(p<0.05),左心室最大正dp/dt从1721±202提高到3600±663 mmHg/秒(p<0.05),时间常数从45.2±5.0降至27.5±4.6毫秒(p<0.01)。在多巴胺基础上加用布那唑嗪可使多巴胺引起的左心室收缩压峰值升高从130±7降至113±8 mmHg(p<0.01)。关于局部室壁运动,LAD闭塞后受损的LAD-δL(节段收缩期缩短)和LAD-Elmax(收缩压峰值-收缩末期长度关系斜率)在输注多巴胺与布那唑嗪后从0.5±2.5%改善到5.9±2.6%(p<0.01),从50±9提高到82±14 mmHg/mm(p<0.01)。多巴胺使心率血压乘积(RPP)从LAD闭塞后的12610±1120大幅增加到16950±1420,而多巴胺与布那唑嗪联合使用时,由于左心室收缩压下降且局部心肌血流变化不大,RPP并未增加。得出的结论是,多巴胺与布那唑嗪联合使用有助于改善缺血心脏的整体和局部心脏功能。