Inotropic stimulation by dobutamine increases left ventricular regional function at the expense of metabolism in hibernating myocardium

Ciro Indolfi, Federico Piscione, Pasquale Perrone-Filardi, Mariella Prastaro, Emilio Di Lorenzo, Luigi Saccà, Marco Salvatore, Mario Condorelli, Massimo Chiariello

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

The mechanism by which dobutamine increases the contraction of chronically dysfunctional myocardium and its effects on metabolism are still unknown. The aim of this study was to assess regional myocardial metabolism at rest and during an intracoronary dobutamine infusion in patients with hibernating myocardium. Eleven asymptomatic patients with single proximal stenosis of the left anterior descending coronary artery end persistent left ventricular dysfunction at rest (undergoing percutaneous transluminal coronary angioplasty [PTCA]) were studied prospectively. Regional left ventricular function was assessed by two-dimensional (2D) echocardiography and regional perfusion by thallium-201 single-proton-emission computed tomography. Great cardiac vein and aortic blood samples were obtained for measurements of lactate and plasma free fatty acid (FFA) concentrations. Inotropic challenge, obtained by using intracoronary dobutamine infusion, increases regional left ventricular function. However, the arteriovenous AV lactate difference was 0.206 ± 0.070 mmol/L at rest, end it decreased to 0.018 ± 0.069 mmol/L (p <0.05 vs baseline) and 0.066 ± 0.068 mmol/L (p <0.05 vs baseline) at 4 and 10 minutes of dobutamine infusion, respectively. Thus the hibernating myocardium does not produce lactate at rest. However, when regional contraction is stimulated, dobutamine-induced inotropic challenge may cause a perfusion-contraction mismatch with an activation of anaerobic glycolysis.

Original languageEnglish
Pages (from-to)542-549
Number of pages8
JournalAmerican Heart Journal
Volume132
Issue number3
DOIs
Publication statusPublished - 1996

Fingerprint

Dobutamine
Left Ventricular Function
Myocardium
Lactic Acid
Echocardiography
Perfusion
Emission-Computed Tomography
Coronary Balloon Angioplasty
Thallium
Left Ventricular Dysfunction
Glycolysis
Nonesterified Fatty Acids
Protons
Veins
Coronary Vessels
Pathologic Constriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Indolfi, C., Piscione, F., Perrone-Filardi, P., Prastaro, M., Di Lorenzo, E., Saccà, L., ... Chiariello, M. (1996). Inotropic stimulation by dobutamine increases left ventricular regional function at the expense of metabolism in hibernating myocardium. American Heart Journal, 132(3), 542-549. https://doi.org/10.1016/S0002-8703(96)90236-7

Inotropic stimulation by dobutamine increases left ventricular regional function at the expense of metabolism in hibernating myocardium. / Indolfi, Ciro; Piscione, Federico; Perrone-Filardi, Pasquale; Prastaro, Mariella; Di Lorenzo, Emilio; Saccà, Luigi; Salvatore, Marco; Condorelli, Mario; Chiariello, Massimo.

In: American Heart Journal, Vol. 132, No. 3, 1996, p. 542-549.

Research output: Contribution to journalArticle

Indolfi, C, Piscione, F, Perrone-Filardi, P, Prastaro, M, Di Lorenzo, E, Saccà, L, Salvatore, M, Condorelli, M & Chiariello, M 1996, 'Inotropic stimulation by dobutamine increases left ventricular regional function at the expense of metabolism in hibernating myocardium', American Heart Journal, vol. 132, no. 3, pp. 542-549. https://doi.org/10.1016/S0002-8703(96)90236-7
Indolfi, Ciro ; Piscione, Federico ; Perrone-Filardi, Pasquale ; Prastaro, Mariella ; Di Lorenzo, Emilio ; Saccà, Luigi ; Salvatore, Marco ; Condorelli, Mario ; Chiariello, Massimo. / Inotropic stimulation by dobutamine increases left ventricular regional function at the expense of metabolism in hibernating myocardium. In: American Heart Journal. 1996 ; Vol. 132, No. 3. pp. 542-549.
@article{d4e4e63fb7fd4c298469a893916800d2,
title = "Inotropic stimulation by dobutamine increases left ventricular regional function at the expense of metabolism in hibernating myocardium",
abstract = "The mechanism by which dobutamine increases the contraction of chronically dysfunctional myocardium and its effects on metabolism are still unknown. The aim of this study was to assess regional myocardial metabolism at rest and during an intracoronary dobutamine infusion in patients with hibernating myocardium. Eleven asymptomatic patients with single proximal stenosis of the left anterior descending coronary artery end persistent left ventricular dysfunction at rest (undergoing percutaneous transluminal coronary angioplasty [PTCA]) were studied prospectively. Regional left ventricular function was assessed by two-dimensional (2D) echocardiography and regional perfusion by thallium-201 single-proton-emission computed tomography. Great cardiac vein and aortic blood samples were obtained for measurements of lactate and plasma free fatty acid (FFA) concentrations. Inotropic challenge, obtained by using intracoronary dobutamine infusion, increases regional left ventricular function. However, the arteriovenous AV lactate difference was 0.206 ± 0.070 mmol/L at rest, end it decreased to 0.018 ± 0.069 mmol/L (p <0.05 vs baseline) and 0.066 ± 0.068 mmol/L (p <0.05 vs baseline) at 4 and 10 minutes of dobutamine infusion, respectively. Thus the hibernating myocardium does not produce lactate at rest. However, when regional contraction is stimulated, dobutamine-induced inotropic challenge may cause a perfusion-contraction mismatch with an activation of anaerobic glycolysis.",
author = "Ciro Indolfi and Federico Piscione and Pasquale Perrone-Filardi and Mariella Prastaro and {Di Lorenzo}, Emilio and Luigi Sacc{\`a} and Marco Salvatore and Mario Condorelli and Massimo Chiariello",
year = "1996",
doi = "10.1016/S0002-8703(96)90236-7",
language = "English",
volume = "132",
pages = "542--549",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Inotropic stimulation by dobutamine increases left ventricular regional function at the expense of metabolism in hibernating myocardium

AU - Indolfi, Ciro

AU - Piscione, Federico

AU - Perrone-Filardi, Pasquale

AU - Prastaro, Mariella

AU - Di Lorenzo, Emilio

AU - Saccà, Luigi

AU - Salvatore, Marco

AU - Condorelli, Mario

AU - Chiariello, Massimo

PY - 1996

Y1 - 1996

N2 - The mechanism by which dobutamine increases the contraction of chronically dysfunctional myocardium and its effects on metabolism are still unknown. The aim of this study was to assess regional myocardial metabolism at rest and during an intracoronary dobutamine infusion in patients with hibernating myocardium. Eleven asymptomatic patients with single proximal stenosis of the left anterior descending coronary artery end persistent left ventricular dysfunction at rest (undergoing percutaneous transluminal coronary angioplasty [PTCA]) were studied prospectively. Regional left ventricular function was assessed by two-dimensional (2D) echocardiography and regional perfusion by thallium-201 single-proton-emission computed tomography. Great cardiac vein and aortic blood samples were obtained for measurements of lactate and plasma free fatty acid (FFA) concentrations. Inotropic challenge, obtained by using intracoronary dobutamine infusion, increases regional left ventricular function. However, the arteriovenous AV lactate difference was 0.206 ± 0.070 mmol/L at rest, end it decreased to 0.018 ± 0.069 mmol/L (p <0.05 vs baseline) and 0.066 ± 0.068 mmol/L (p <0.05 vs baseline) at 4 and 10 minutes of dobutamine infusion, respectively. Thus the hibernating myocardium does not produce lactate at rest. However, when regional contraction is stimulated, dobutamine-induced inotropic challenge may cause a perfusion-contraction mismatch with an activation of anaerobic glycolysis.

AB - The mechanism by which dobutamine increases the contraction of chronically dysfunctional myocardium and its effects on metabolism are still unknown. The aim of this study was to assess regional myocardial metabolism at rest and during an intracoronary dobutamine infusion in patients with hibernating myocardium. Eleven asymptomatic patients with single proximal stenosis of the left anterior descending coronary artery end persistent left ventricular dysfunction at rest (undergoing percutaneous transluminal coronary angioplasty [PTCA]) were studied prospectively. Regional left ventricular function was assessed by two-dimensional (2D) echocardiography and regional perfusion by thallium-201 single-proton-emission computed tomography. Great cardiac vein and aortic blood samples were obtained for measurements of lactate and plasma free fatty acid (FFA) concentrations. Inotropic challenge, obtained by using intracoronary dobutamine infusion, increases regional left ventricular function. However, the arteriovenous AV lactate difference was 0.206 ± 0.070 mmol/L at rest, end it decreased to 0.018 ± 0.069 mmol/L (p <0.05 vs baseline) and 0.066 ± 0.068 mmol/L (p <0.05 vs baseline) at 4 and 10 minutes of dobutamine infusion, respectively. Thus the hibernating myocardium does not produce lactate at rest. However, when regional contraction is stimulated, dobutamine-induced inotropic challenge may cause a perfusion-contraction mismatch with an activation of anaerobic glycolysis.

UR - http://www.scopus.com/inward/record.url?scp=0029909776&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029909776&partnerID=8YFLogxK

U2 - 10.1016/S0002-8703(96)90236-7

DO - 10.1016/S0002-8703(96)90236-7

M3 - Article

C2 - 8800023

AN - SCOPUS:0029909776

VL - 132

SP - 542

EP - 549

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 3

ER -