De Marco T, Kwasman M, Lau D, Chatterjee K
Department of Medicine, University of California, San Francisco 94143.
Am J Cardiol. 1988 Aug 11;62(5):57C-62C.
Dopexamine hydrochloride is a new intravenous, short-acting agent with agonist activity at beta 2-adrenergic and DA1-dopaminergic receptors. The effects of dopexamine hydrochloride infusion on systemic and coronary hemodynamics, myocardial metabolism and the neuroendocrine system were evaluated in 10 patients with chronic severe congestive heart failure at baseline, at rates of 1, 2, 4 and 6 micrograms/kg/min at 15-minute intervals, and after a 1-hour infusion of the "optimal" dose. Right atrial pressure was reduced by 25% (p less than 0.01), pulmonary capillary wedge pressure by 26% (p less than 0.05), systemic vascular resistance by 44% (p less than 0.001) and pulmonary vascular resistance by 34% (p less than 0.01) after the optimal dose. Heart rate increased by 17% (p less than 0.01), rate-pressure product by 17% (p less than 0.01) and stroke volume index by 31% (p less than 0.001). There was no change in mean arterial pressure, myocardial oxygen consumption, coronary sinus blood flow, myocardial oxygen extraction or norepinephrine balance. None of the patients demonstrated net myocardial lactate production. These findings suggest that dopexamine hydrochloride improves systemic hemodynamics and cardiac performance without adversely affecting myocardial energetics or norepinephrine balance. Thus, dopexamine hydrochloride may be a useful agent for the short-term treatment of congestive heart failure.
盐酸多培沙明是一种新型静脉注射短效药物，对β2 - 肾上腺素能受体和DA1 - 多巴胺能受体具有激动活性。在10例慢性重度充血性心力衰竭患者中，于基线状态、每隔15分钟以1、2、4和6微克/千克/分钟的速率输注，以及在输注1小时“最佳”剂量后，评估了盐酸多培沙明输注对全身和冠状动脉血流动力学、心肌代谢及神经内分泌系统的影响。在给予最佳剂量后，右心房压力降低了25%（p < 0.01），肺毛细血管楔压降低了26%（p < 0.05），全身血管阻力降低了44%（p < 0.001），肺血管阻力降低了34%（p < 0.01）。心率增加了17%（p < 0.01），心率 - 血压乘积增加了17%（p < 0.01），每搏量指数增加了31%（p < 0.001）。平均动脉压、心肌耗氧量、冠状窦血流量、心肌氧摄取或去甲肾上腺素平衡均无变化。所有患者均未表现出净心肌乳酸生成。这些发现表明，盐酸多培沙明可改善全身血流动力学和心脏功能，而不会对心肌能量代谢或去甲肾上腺素平衡产生不利影响。因此，盐酸多培沙明可能是用于充血性心力衰竭短期治疗的一种有用药物。
