Tan L B, Littler W A, Murray R G
Cardiology Department, East Birmingham Hospital, England.
J Cardiovasc Pharmacol. 1987 Sep;10(3):280-6. doi: 10.1097/00005344-198709000-00005.
Dopexamine is a novel compound that has DA1-dopaminergic and beta 2-adrenergic agonist properties capable of producing beneficial systemic and renal vasodilation. The acute haemodynamic effects in 10 patients with low-output-state ischaemic cardiac failure (NYHA IV) were recorded before (control) and during graded incremental doses of dopexamine infusion from 0.5 to 6.0 micrograms/kg/min. Dopexamine produced a marked increase in cardiac index from 1.6 +/- 0.2 (control) to a maximum of 2.8 +/- 0.4 L/min/m2 (p less than 0.001) primarily by inducing vasodilation, with reduction in systemic vascular resistance from 1,720 +/- 136 (control) to 1,116 +/- 136 dynes.s.cm-5 (p less than 0.05). Using a more sophisticated analytical technique which enables us to separate direct inotropic from vasodilatory effects, we were able to identify, in eight of the patients, a direct dopexamine-induced positive inotropism. These beneficial central haemodynamic effects of dopexamine, when coupled with its known DA1-dopaminergic agonist property, indicate that dopexamine may have a place in the management of patients in severe heart failure.
多培沙明是一种新型化合物，具有DA1多巴胺能和β2肾上腺素能激动剂特性，能够产生有益的全身和肾血管舒张作用。记录了10例低输出量状态缺血性心力衰竭（纽约心脏协会IV级）患者在（对照）给药前以及多培沙明以0.5至6.0微克/千克/分钟的剂量递增输注期间的急性血流动力学效应。多培沙明主要通过诱导血管舒张，使心脏指数从1.6±0.2（对照）显著增加至最高2.8±0.4升/分钟/平方米（p<0.001），全身血管阻力从1720±136（对照）降至1116±136达因·秒·厘米⁻⁵（p<0.05）。使用一种更复杂的分析技术，使我们能够区分直接的正性肌力作用和血管舒张作用，我们在8例患者中识别出多培沙明直接诱导的正性肌力作用。多培沙明的这些有益的中心血流动力学效应，再加上其已知的DA1多巴胺能激动剂特性，表明多培沙明在严重心力衰竭患者的治疗中可能占有一席之地。
