Yu Fengxia, Liu Dong, Ma Xia, Liu Yawen, Cai Linkun, Zhao Erwei, Huang Zixu, Zhang Zhe, Zhang Tingting, Qiao PengGang, Zheng Wei, Guo Chunyan, Qian Linxue, Ren Pengling, Wang Zhenchang
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Brain Res Bull. 2025 Feb;221:111204. doi: 10.1016/j.brainresbull.2025.111204. Epub 2025 Jan 8.
Dobutamine, a sympathomimetic agent, is widely used clinically, influencing cardiac output, heart rate (HR), and blood pressure (BP), which may impact cerebral blood flow (CBF), critical for brain metabolism. However, the effects of dobutamine on CBF and internal carotid artery (ICA) blood flow remain unclear, with contradictory reported in both clinical and animal studies. It is necessary to investigate the effects of dobutamine on cervical and cerebral hemodynamics. This study aimed to evaluate the effects of dobutamine infusion on ICA blood flow and CBF, explore their relationship, and identify factors influencing CBF to facilitate timely monitoring in clinical practice.
Forty-eight healthy volunteers underwent physiological assessment, ICA ultrasound, and brain magnetic resonance imaging (MRI) data before and after the administration of dobutamine. Paired t and Wilcoxon signed-rank tests were used to analyze changes, while logistic regression explored associations between hemodynamic factors and CBF.
Dobutamine infusion significantly increased HR, respiration rate, systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure, while blood oxygen remained stable. Compared with those in the resting state, the peak systolic velocity (Vs), resistance index, pulsatility index, and systolic/diastolic ratio (S/D) increased, whereas end-diastolic velocity (Vd) decreased. ICA diameter and mean velocity showed no significant changes. CBF significantly decreased in the anterior and middle cerebral arteries. Logistic regression identified SBP, DBP, and S/D difference as key factors associated with CBF reduction.
Dobutamine altered ICA hemodynamics and reduced CBF in anterior and middle cerebral arteries. Real-time ICA ultrasound monitoring provides valuable guidance during clinical use.
多巴酚丁胺是一种拟交感神经药，在临床上广泛应用，可影响心输出量、心率（HR）和血压（BP），这可能会影响对脑代谢至关重要的脑血流量（CBF）。然而，多巴酚丁胺对CBF和颈内动脉（ICA）血流的影响仍不清楚，临床和动物研究中均有相互矛盾的报道。有必要研究多巴酚丁胺对颈部和脑血流动力学的影响。本研究旨在评估多巴酚丁胺输注对ICA血流和CBF的影响，探讨它们之间的关系，并确定影响CBF的因素，以便在临床实践中进行及时监测。
48名健康志愿者在给予多巴酚丁胺前后接受了生理评估、ICA超声检查和脑磁共振成像（MRI）数据采集。采用配对t检验和Wilcoxon符号秩检验分析变化情况，同时使用逻辑回归探索血流动力学因素与CBF之间的关联。
多巴酚丁胺输注显著增加了HR、呼吸频率、收缩压（SBP）、舒张压（DBP）和平均动脉压，而血氧保持稳定。与静息状态相比，收缩期峰值速度（Vs）、阻力指数、搏动指数和收缩/舒张比（S/D）增加，而舒张末期速度（Vd）降低。ICA直径和平均速度无显著变化。大脑前动脉和大脑中动脉的CBF显著降低。逻辑回归确定SBP、DBP和S/D差异是与CBF降低相关的关键因素。
多巴酚丁胺改变了ICA血流动力学，降低了大脑前动脉和大脑中动脉的CBF。实时ICA超声监测在临床使用过程中提供了有价值的指导。
