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 language | English |
|---|---|
| Pages (from-to) | 542-549 |
| Number of pages | 8 |
| Journal | American Heart Journal |
| Volume | 132 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 1996 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
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 journal › Article
}
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 -