Impact of short-term intermittent intravenous dobutamine therapy on endothelial function in patients with severe chronic heart failure
Intermittent intravenous dobutamine therapy is used to treat patients with decompensated end-stage chronic heart failure (CHF), in whom the vascular endothelium is usually impaired. Although it has been suggested that modification or reversal of endothelial dysfunction may be of significant therapeu...
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| Veröffentlicht in: | The American heart journal 2004-11, Vol.148 (5), p.878-882 |
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| creator | Freimark, Dov Feinberg, Micha S. Matezky, Shlomi Hochberg, Naomi Shechter, Michael |
| description | Intermittent intravenous dobutamine therapy is used to treat patients with decompensated end-stage chronic heart failure (CHF), in whom the vascular endothelium is usually impaired. Although it has been suggested that modification or reversal of endothelial dysfunction may be of significant therapeutic benefit, the impact of short-term intermittent intravenous dobutamine therapy on flow-mediated dilation (FMD) in patients with severe decompensated end-stage chronic CHF has not been assessed.
We prospectively assessed the impact of intermittent intravenous low-dose dobutamine therapy on endothelium-dependent brachial artery FMD and endothelium-independent nitroglycerin (NTG)-mediated vasodilation using high resolution ultrasound scanning in 20 consecutive male patients with severe CHF and ischemic cardiomyopathy (New York Heart Association functional class IV), at baseline and after 4 months, and compared them to 20 age- and sex-matched control subjects. The cardiac index (CI), stroke index (SI), and systemic vascular resistance (SVR) were assessed non-invasively with a thoracic electrical bioimpedance device before and after intravenous dobutamine therapy.
Intermittent intravenous dobutamine therapy resulted in significant improvement in post-intervention FMD compared with baseline (7.7% ± 2.4% vs 1.1% ± 2.6%;
P = .001), a finding not evident in control subjects (1.3% ± 2.6% vs 1.2% ± 2.1%;
P = .78). There was no significant effect of dobutamine treatment compared with control subjects on NTG-induced vasodilation (7.6% ± 5.5% vs 7.5% ± 8.8%,
P = .979). Short-term dobutamine therapy also significantly improved SVR (1797 ± 926 dyne sec/cm
5 vs 2172 ± 1133 dyne sec/cm
5,
P = .05), CI (2. 4± 0.6 L/min/m
2 vs 1.9 ± 0.6 L/min/m
2,
P = .01), and SI (33.5 ± 11.7 mL/m
2 vs 27.2 ± 12.4 mL/m
2,
P = .02).
Short-term intermittent intravenous low-dose dobutamine therapy significantly improved vascular endothelial function, perhaps demonstrating an additional mechanism for improved SVR, CI, and SI in patients with severe CHF. |
| doi_str_mv | 10.1016/j.ahj.2004.04.013 |
| format | Article |
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We prospectively assessed the impact of intermittent intravenous low-dose dobutamine therapy on endothelium-dependent brachial artery FMD and endothelium-independent nitroglycerin (NTG)-mediated vasodilation using high resolution ultrasound scanning in 20 consecutive male patients with severe CHF and ischemic cardiomyopathy (New York Heart Association functional class IV), at baseline and after 4 months, and compared them to 20 age- and sex-matched control subjects. The cardiac index (CI), stroke index (SI), and systemic vascular resistance (SVR) were assessed non-invasively with a thoracic electrical bioimpedance device before and after intravenous dobutamine therapy.
Intermittent intravenous dobutamine therapy resulted in significant improvement in post-intervention FMD compared with baseline (7.7% ± 2.4% vs 1.1% ± 2.6%;
P = .001), a finding not evident in control subjects (1.3% ± 2.6% vs 1.2% ± 2.1%;
P = .78). There was no significant effect of dobutamine treatment compared with control subjects on NTG-induced vasodilation (7.6% ± 5.5% vs 7.5% ± 8.8%,
P = .979). Short-term dobutamine therapy also significantly improved SVR (1797 ± 926 dyne sec/cm
5 vs 2172 ± 1133 dyne sec/cm
5,
P = .05), CI (2. 4± 0.6 L/min/m
2 vs 1.9 ± 0.6 L/min/m
2,
P = .01), and SI (33.5 ± 11.7 mL/m
2 vs 27.2 ± 12.4 mL/m
2,
P = .02).
Short-term intermittent intravenous low-dose dobutamine therapy significantly improved vascular endothelial function, perhaps demonstrating an additional mechanism for improved SVR, CI, and SI in patients with severe CHF.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2004.04.013</identifier><identifier>PMID: 15523321</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adrenergic beta-Agonists - administration & dosage ; Adult ; Aged ; Biological and medical sciences ; Brachial Artery - drug effects ; Cardiology. Vascular system ; Cholesterol ; Dobutamine - administration & dosage ; Drug therapy ; Drug Therapy, Combination ; Endothelium, Vascular - drug effects ; Endothelium, Vascular - physiology ; Heart ; Heart attacks ; Heart Failure - diagnostic imaging ; Heart Failure - drug therapy ; Heart Failure - etiology ; Heart Failure - physiopathology ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Infusions, Intravenous ; Male ; Medical sciences ; Middle Aged ; Myocardial Ischemia - complications ; Nitroglycerin - pharmacology ; Prospective Studies ; Ultrasonography ; Vasodilation - drug effects ; Vasodilator Agents - pharmacology ; Veins & arteries</subject><ispartof>The American heart journal, 2004-11, Vol.148 (5), p.878-882</ispartof><rights>2004 Elsevier Inc.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Elsevier Limited Nov 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-2b141030096476182502acdc6f0590179d59557ad5177a5170e017e1fed27d13</citedby><cites>FETCH-LOGICAL-c409t-2b141030096476182502acdc6f0590179d59557ad5177a5170e017e1fed27d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1504470032?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16268717$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15523321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Freimark, Dov</creatorcontrib><creatorcontrib>Feinberg, Micha S.</creatorcontrib><creatorcontrib>Matezky, Shlomi</creatorcontrib><creatorcontrib>Hochberg, Naomi</creatorcontrib><creatorcontrib>Shechter, Michael</creatorcontrib><title>Impact of short-term intermittent intravenous dobutamine therapy on endothelial function in patients with severe chronic heart failure</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Intermittent intravenous dobutamine therapy is used to treat patients with decompensated end-stage chronic heart failure (CHF), in whom the vascular endothelium is usually impaired. Although it has been suggested that modification or reversal of endothelial dysfunction may be of significant therapeutic benefit, the impact of short-term intermittent intravenous dobutamine therapy on flow-mediated dilation (FMD) in patients with severe decompensated end-stage chronic CHF has not been assessed.
We prospectively assessed the impact of intermittent intravenous low-dose dobutamine therapy on endothelium-dependent brachial artery FMD and endothelium-independent nitroglycerin (NTG)-mediated vasodilation using high resolution ultrasound scanning in 20 consecutive male patients with severe CHF and ischemic cardiomyopathy (New York Heart Association functional class IV), at baseline and after 4 months, and compared them to 20 age- and sex-matched control subjects. The cardiac index (CI), stroke index (SI), and systemic vascular resistance (SVR) were assessed non-invasively with a thoracic electrical bioimpedance device before and after intravenous dobutamine therapy.
Intermittent intravenous dobutamine therapy resulted in significant improvement in post-intervention FMD compared with baseline (7.7% ± 2.4% vs 1.1% ± 2.6%;
P = .001), a finding not evident in control subjects (1.3% ± 2.6% vs 1.2% ± 2.1%;
P = .78). There was no significant effect of dobutamine treatment compared with control subjects on NTG-induced vasodilation (7.6% ± 5.5% vs 7.5% ± 8.8%,
P = .979). Short-term dobutamine therapy also significantly improved SVR (1797 ± 926 dyne sec/cm
5 vs 2172 ± 1133 dyne sec/cm
5,
P = .05), CI (2. 4± 0.6 L/min/m
2 vs 1.9 ± 0.6 L/min/m
2,
P = .01), and SI (33.5 ± 11.7 mL/m
2 vs 27.2 ± 12.4 mL/m
2,
P = .02).
Short-term intermittent intravenous low-dose dobutamine therapy significantly improved vascular endothelial function, perhaps demonstrating an additional mechanism for improved SVR, CI, and SI in patients with severe CHF.</description><subject>Adrenergic beta-Agonists - administration & dosage</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Brachial Artery - drug effects</subject><subject>Cardiology. Vascular system</subject><subject>Cholesterol</subject><subject>Dobutamine - administration & dosage</subject><subject>Drug therapy</subject><subject>Drug Therapy, Combination</subject><subject>Endothelium, Vascular - drug effects</subject><subject>Endothelium, Vascular - physiology</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - etiology</subject><subject>Heart Failure - physiopathology</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Ischemia - complications</subject><subject>Nitroglycerin - pharmacology</subject><subject>Prospective Studies</subject><subject>Ultrasonography</subject><subject>Vasodilation - drug effects</subject><subject>Vasodilator Agents - pharmacology</subject><subject>Veins & arteries</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kc9q3DAQxkVpaTZpH6CXIijtzduRbElreiqhfwKBXnIXWnmMZWzJleQteYE-d2V2IdBDYNAww28-RvMR8o7BngGTn8e9GcY9B2j2W7D6BdkxaFUlVdO8JDsA4NVBQX1FrlMaSyn5Qb4mV0wIXtec7cjfu3kxNtPQ0zSEmKuMcabOb8nljD5vRTQn9GFNtAvHNZvZeaR5wGiWRxo8Rd-FUk7OTLRfvc2uNJ2ni8muKCT6x-WBJjxhRGqHGLyzdEATM-2Nm9aIb8ir3kwJ317yDXn4_u3h9md1_-vH3e3X-8o20OaKH1nDoAZoZaMkO3AB3NjOyh5EC0y1nWiFUKYTTClTHsDSRdZjx1XH6hvy6Sy7xPB7xZT17JLFaTIey_e0LLeSXDQF_PAfOIY1-rKaZgKaRgHUvFDsTNkYUorY6yW62cRHzUBvDulRF4f05pDegtVl5v1FeT3O2D1NXCwpwMcLYJI1Ux-Nty49cZLLg2KqcF_OHJZ7nRxGnWy5tsXORbRZd8E9s8Y_7Y6vCA</recordid><startdate>20041101</startdate><enddate>20041101</enddate><creator>Freimark, Dov</creator><creator>Feinberg, Micha S.</creator><creator>Matezky, Shlomi</creator><creator>Hochberg, Naomi</creator><creator>Shechter, Michael</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20041101</creationdate><title>Impact of short-term intermittent intravenous dobutamine therapy on endothelial function in patients with severe chronic heart failure</title><author>Freimark, Dov ; Feinberg, Micha S. ; Matezky, Shlomi ; Hochberg, Naomi ; Shechter, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-2b141030096476182502acdc6f0590179d59557ad5177a5170e017e1fed27d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adrenergic beta-Agonists - administration & dosage</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Brachial Artery - drug effects</topic><topic>Cardiology. Vascular system</topic><topic>Cholesterol</topic><topic>Dobutamine - administration & dosage</topic><topic>Drug therapy</topic><topic>Drug Therapy, Combination</topic><topic>Endothelium, Vascular - drug effects</topic><topic>Endothelium, Vascular - physiology</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - etiology</topic><topic>Heart Failure - physiopathology</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Ischemia - complications</topic><topic>Nitroglycerin - pharmacology</topic><topic>Prospective Studies</topic><topic>Ultrasonography</topic><topic>Vasodilation - drug effects</topic><topic>Vasodilator Agents - pharmacology</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Freimark, Dov</creatorcontrib><creatorcontrib>Feinberg, Micha S.</creatorcontrib><creatorcontrib>Matezky, Shlomi</creatorcontrib><creatorcontrib>Hochberg, Naomi</creatorcontrib><creatorcontrib>Shechter, Michael</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Freimark, Dov</au><au>Feinberg, Micha S.</au><au>Matezky, Shlomi</au><au>Hochberg, Naomi</au><au>Shechter, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of short-term intermittent intravenous dobutamine therapy on endothelial function in patients with severe chronic heart failure</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2004-11-01</date><risdate>2004</risdate><volume>148</volume><issue>5</issue><spage>878</spage><epage>882</epage><pages>878-882</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Intermittent intravenous dobutamine therapy is used to treat patients with decompensated end-stage chronic heart failure (CHF), in whom the vascular endothelium is usually impaired. Although it has been suggested that modification or reversal of endothelial dysfunction may be of significant therapeutic benefit, the impact of short-term intermittent intravenous dobutamine therapy on flow-mediated dilation (FMD) in patients with severe decompensated end-stage chronic CHF has not been assessed.
We prospectively assessed the impact of intermittent intravenous low-dose dobutamine therapy on endothelium-dependent brachial artery FMD and endothelium-independent nitroglycerin (NTG)-mediated vasodilation using high resolution ultrasound scanning in 20 consecutive male patients with severe CHF and ischemic cardiomyopathy (New York Heart Association functional class IV), at baseline and after 4 months, and compared them to 20 age- and sex-matched control subjects. The cardiac index (CI), stroke index (SI), and systemic vascular resistance (SVR) were assessed non-invasively with a thoracic electrical bioimpedance device before and after intravenous dobutamine therapy.
Intermittent intravenous dobutamine therapy resulted in significant improvement in post-intervention FMD compared with baseline (7.7% ± 2.4% vs 1.1% ± 2.6%;
P = .001), a finding not evident in control subjects (1.3% ± 2.6% vs 1.2% ± 2.1%;
P = .78). There was no significant effect of dobutamine treatment compared with control subjects on NTG-induced vasodilation (7.6% ± 5.5% vs 7.5% ± 8.8%,
P = .979). Short-term dobutamine therapy also significantly improved SVR (1797 ± 926 dyne sec/cm
5 vs 2172 ± 1133 dyne sec/cm
5,
P = .05), CI (2. 4± 0.6 L/min/m
2 vs 1.9 ± 0.6 L/min/m
2,
P = .01), and SI (33.5 ± 11.7 mL/m
2 vs 27.2 ± 12.4 mL/m
2,
P = .02).
Short-term intermittent intravenous low-dose dobutamine therapy significantly improved vascular endothelial function, perhaps demonstrating an additional mechanism for improved SVR, CI, and SI in patients with severe CHF.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>15523321</pmid><doi>10.1016/j.ahj.2004.04.013</doi><tpages>5</tpages></addata></record> |
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| ispartof | The American heart journal, 2004-11, Vol.148 (5), p.878-882 |
| issn | 0002-8703 1097-6744 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; ProQuest Central UK/Ireland |
| subjects | Adrenergic beta-Agonists - administration & dosage Adult Aged Biological and medical sciences Brachial Artery - drug effects Cardiology. Vascular system Cholesterol Dobutamine - administration & dosage Drug therapy Drug Therapy, Combination Endothelium, Vascular - drug effects Endothelium, Vascular - physiology Heart Heart attacks Heart Failure - diagnostic imaging Heart Failure - drug therapy Heart Failure - etiology Heart Failure - physiopathology Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Infusions, Intravenous Male Medical sciences Middle Aged Myocardial Ischemia - complications Nitroglycerin - pharmacology Prospective Studies Ultrasonography Vasodilation - drug effects Vasodilator Agents - pharmacology Veins & arteries |
| title | Impact of short-term intermittent intravenous dobutamine therapy on endothelial function in patients with severe chronic heart failure |
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