Tomita H, Ikeda K, Chiba S
Department of Pediatrics, School of Medicine, Sapporo Medical University, Japan.
Tohoku J Exp Med. 1994 Feb;172(2):111-21. doi: 10.1620/tjem.172.111.
The purpose of this study is to evaluate hemodynamic effects and clinical benefit of oral denopamine in infants with left to right shunt disease. We measured heart rates, left ventricular end-diastolic and end-systolic dimensions, shortening fractions, peak and mean flow velocities of the main pulmonary artery and ascending aorta at 30, 60 and 90 min after oral denopamine using Doppler echocardiography. Seventeen infants with ventricular septal defect and pulmonary hypertension (mean pulmonary artery pressures higher than 25 mmHg) were divided into two groups depending upon the doses of denopamine; group 1 received 1 mg/kg, and group 2 was given 0.5 mg/kg. Serum concentrations of denopamine were measured with high performance liquid chromatography after completion of these evaluations. In both groups, heart rates and left ventricular shortening fractions increased, and left ventricular end-systolic dimensions decreased significantly. Although peak and mean velocities of aortic and pulmonary flows increased significantly, there were no significant alterations in peak and mean velocity ratios of pulmonary to aortic flow. There was no significant difference in the serum concentration of denopamine between the two groups. However, percentage changes of some indices, such as heart rates, left ventricular end-systolic dimensions, peak aortic and pulmonary flow velocities, and mean aortic flow velocities exponentially correlated to serum concentrations of denopamine. In conclusion, denopamine is supposed to have beneficial actions to augment the systemic output by enhancing the left ventricular pump function in patients of ventricular septal defect. However, we should be careful for denopamine not to produce excessive increases in heart rate and pulmonary blood flow.
本研究的目的是评估口服多巴胺对左向右分流性疾病婴儿的血流动力学影响和临床益处。我们使用多普勒超声心动图在口服多巴胺后30、60和90分钟测量心率、左心室舒张末期和收缩末期内径、缩短分数、主肺动脉和升主动脉的峰值和平均流速。17例室间隔缺损合并肺动脉高压（平均肺动脉压高于25 mmHg）的婴儿根据多巴胺剂量分为两组；第1组接受1 mg/kg，第2组给予0.5 mg/kg。在完成这些评估后，用高效液相色谱法测量血清多巴胺浓度。两组的心率和左心室缩短分数均增加，左心室收缩末期内径显著减小。虽然主动脉和肺血流的峰值和平均流速显著增加，但肺与主动脉血流的峰值和平均流速比值无显著变化。两组间多巴胺血清浓度无显著差异。然而，一些指标的百分比变化，如心率、左心室收缩末期内径、主动脉和肺血流峰值流速以及主动脉平均流速，与多巴胺血清浓度呈指数相关。总之，多巴胺通过增强室间隔缺损患者的左心室泵功能，可能对增加全身输出量有有益作用。然而，我们应注意多巴胺不要使心率和肺血流量过度增加。
