Sustained improvement in flow-mediated vasodilation after short-term administration of dobutamine in patients with severe congestive heart failure

In patients with severe congestive heart failure (CHF), short-term administration of dobutamine exerts sustained clinical benefits that are partially mediated by a training-like effect on skeletal muscle. Recently, physical training has been shown to enhance endothelial function in the skeletal musc...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1999-01, Vol.99 (1), p.60-64
Main Authors: PATEL, M. B, KAPLAN, I. V, PATNI, R. N, LEVY, D, STROM, J. A, SHIRANI, J, LEJEMTEL, T. H
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood Flow Velocity
Brachial Artery - drug effects
Cardiotonic Agents - therapeutic use
Cardiovascular system
Dobutamine - therapeutic use
Drug Administration Schedule
Female
Heart Failure - drug therapy
Humans
Male
Medical sciences
Middle Aged
Miscellaneous
Pharmacology. Drug treatments
Vasodilator Agents - therapeutic use
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Summary:In patients with severe congestive heart failure (CHF), short-term administration of dobutamine exerts sustained clinical benefits that are partially mediated by a training-like effect on skeletal muscle. Recently, physical training has been shown to enhance endothelial function in the skeletal muscle vasculature by improving endothelial function. Whether the dobutamine-induced training effect is also associated with an improvement in endothelial function in the skeletal muscle vasculature is currently unknown. Flow-mediated vasodilation in response to peak reactive hyperemia was evaluated in the forearms of 9 patients with severe CHF who were treated with dobutamine for 72 hours. Resting and peak hyperemic brachial artery blood flow and diameter (BABF [mL/min] and BAD [mm], respectively) were measured by 2-dimensional and Doppler ultrasonography at baseline, at 3 and 72 hours during dobutamine infusion, and at 2 and 4 weeks after discontinuation of dobutamine therapy. In addition, the brachial artery response to sublingual (SL) administration of nitroglycerin (NTG) was evaluated at baseline and at 2 and 4 weeks after discontinuation of dobutamine therapy. Ten patients with severe CHF who did not receive dobutamine served as control subjects. Resting BABF was significantly increased at 3 and 72 hours (391.2+/-31.8 and 366.8+/-31.0 mL/min, respectively, compared with 289.8+/-18.6 mL/min at baseline; P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.99.1.60