The effects of β-adrenergic stimulation on the length-dependent regulation of myocardial function in coronary surgery patients
Increasing cardiac load by leg elevation identifies patients with load-dependent impairment of left ventricular (LV) function. This impairment is related to a deficient length-dependent regulation of LV function. We investigated the effects of dobutamine on length-dependent regulation of LV function...
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| Veröffentlicht in: | Anesthesia and analgesia 1999-10, Vol.89 (4), p.835-842 |
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| creator | DE HERT, S. G VAN DER LINDEN, P. J TEN BROECKE, P. W RODRIGUS, I. E SERMEUS, L. A MOULIJN, A. C GILLEBERT, T. C |
| description | Increasing cardiac load by leg elevation identifies patients with load-dependent impairment of left ventricular (LV) function. This impairment is related to a deficient length-dependent regulation of LV function. We investigated the effects of dobutamine on length-dependent regulation of LV function in coronary surgery patients (n = 25). High-fidelity LV pressure tracings were obtained at end-expiration, while hearts were paced at a fixed rate of 90 bpm. Effects of leg elevation on contraction and relaxation were compared before and during dobutamine 5 microg x kg(-1) x min(-1). Effects on contraction were evaluated by analysis of changes in dP/dtmax. Effects on relaxation were assessed by analysis of R (slope of the relation between the time constant of isovolumic relaxation and end-systolic pressure). Correlations were calculated with linear regression analysis using Pearson's coefficient r. The effects of leg elevation on variables of contraction and relaxation were coupled. We found a close relationship between changes in dP/dtmax and individual values of R (r = 0.84; P < 0.001). Dobutamine improved myocardial function and accelerated LV pressure decrease. Under dobutamine, the increase in dP/dtmax with leg elevation was larger (P < 0.001) and load dependence of LV relaxation was reduced (P = 0.001). Dobutamine improved the effects of leg elevation on LV function, reflecting improved length-dependent regulation of LV function.
This study demonstrated that beta-adrenoreceptor stimulation with dobutamine improved length-dependent regulation of myocardial function assessed during leg elevation in cardiac surgical patients. |
| doi_str_mv | 10.1097/00000539-199910000-00005 |
| format | Article |
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This study demonstrated that beta-adrenoreceptor stimulation with dobutamine improved length-dependent regulation of myocardial function assessed during leg elevation in cardiac surgical patients.</description><identifier>ISSN: 0003-2999</identifier><identifier>EISSN: 1526-7598</identifier><identifier>DOI: 10.1097/00000539-199910000-00005</identifier><identifier>PMID: 10512252</identifier><identifier>CODEN: AACRAT</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adrenergic beta-Agonists - administration & dosage ; Adrenergic beta-Agonists - therapeutic use ; Aged ; Biological and medical sciences ; Cardiac Output - drug effects ; Cardiac Pacing, Artificial ; Cardiac Volume - drug effects ; Cardiotonic agents ; Cardiotonic Agents - administration & dosage ; Cardiotonic Agents - therapeutic use ; Cardiovascular system ; Coronary Artery Bypass ; Dobutamine - administration & dosage ; Dobutamine - therapeutic use ; Elective Surgical Procedures ; Female ; Heart Rate ; Humans ; Leg - physiology ; Linear Models ; Male ; Medical sciences ; Myocardial Contraction - drug effects ; Pharmacology. Drug treatments ; Posture ; Stroke Volume - drug effects ; Ventricular Function, Left - drug effects ; Ventricular Pressure - drug effects</subject><ispartof>Anesthesia and analgesia, 1999-10, Vol.89 (4), p.835-842</ispartof><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-9a68f682d3bd2f8cd8cadf5a32546f25afcb5c09b401cfdc63fce7df16a4b6603</citedby><cites>FETCH-LOGICAL-c340t-9a68f682d3bd2f8cd8cadf5a32546f25afcb5c09b401cfdc63fce7df16a4b6603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1962023$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10512252$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DE HERT, S. G</creatorcontrib><creatorcontrib>VAN DER LINDEN, P. J</creatorcontrib><creatorcontrib>TEN BROECKE, P. W</creatorcontrib><creatorcontrib>RODRIGUS, I. E</creatorcontrib><creatorcontrib>SERMEUS, L. A</creatorcontrib><creatorcontrib>MOULIJN, A. C</creatorcontrib><creatorcontrib>GILLEBERT, T. C</creatorcontrib><title>The effects of β-adrenergic stimulation on the length-dependent regulation of myocardial function in coronary surgery patients</title><title>Anesthesia and analgesia</title><addtitle>Anesth Analg</addtitle><description>Increasing cardiac load by leg elevation identifies patients with load-dependent impairment of left ventricular (LV) function. This impairment is related to a deficient length-dependent regulation of LV function. We investigated the effects of dobutamine on length-dependent regulation of LV function in coronary surgery patients (n = 25). High-fidelity LV pressure tracings were obtained at end-expiration, while hearts were paced at a fixed rate of 90 bpm. Effects of leg elevation on contraction and relaxation were compared before and during dobutamine 5 microg x kg(-1) x min(-1). Effects on contraction were evaluated by analysis of changes in dP/dtmax. Effects on relaxation were assessed by analysis of R (slope of the relation between the time constant of isovolumic relaxation and end-systolic pressure). Correlations were calculated with linear regression analysis using Pearson's coefficient r. The effects of leg elevation on variables of contraction and relaxation were coupled. We found a close relationship between changes in dP/dtmax and individual values of R (r = 0.84; P < 0.001). Dobutamine improved myocardial function and accelerated LV pressure decrease. Under dobutamine, the increase in dP/dtmax with leg elevation was larger (P < 0.001) and load dependence of LV relaxation was reduced (P = 0.001). Dobutamine improved the effects of leg elevation on LV function, reflecting improved length-dependent regulation of LV function.
This study demonstrated that beta-adrenoreceptor stimulation with dobutamine improved length-dependent regulation of myocardial function assessed during leg elevation in cardiac surgical patients.</description><subject>Adrenergic beta-Agonists - administration & dosage</subject><subject>Adrenergic beta-Agonists - therapeutic use</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiac Output - drug effects</subject><subject>Cardiac Pacing, Artificial</subject><subject>Cardiac Volume - drug effects</subject><subject>Cardiotonic agents</subject><subject>Cardiotonic Agents - administration & dosage</subject><subject>Cardiotonic Agents - therapeutic use</subject><subject>Cardiovascular system</subject><subject>Coronary Artery Bypass</subject><subject>Dobutamine - administration & dosage</subject><subject>Dobutamine - therapeutic use</subject><subject>Elective Surgical Procedures</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Leg - physiology</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Myocardial Contraction - drug effects</subject><subject>Pharmacology. Drug treatments</subject><subject>Posture</subject><subject>Stroke Volume - drug effects</subject><subject>Ventricular Function, Left - drug effects</subject><subject>Ventricular Pressure - drug effects</subject><issn>0003-2999</issn><issn>1526-7598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkE1OHDEQha0oURgmuULkBWLnxD9jt71ECJJISNmQdctdLg8ddbsHu3vBijtxkJwpHmaAlEoq1dP3ytYjhAr-VXDXfOP70sox4ZwT-4U9K-_ISmhpWKOdfU9WVVJMVuSEnJbyp66CW_ORnAiuhZRarsjj7R1SjBFhLnSK9O8T8yFjwrztgZa5H5fBz_2UaO25sgOm7XzHAu4wBUwzzbh9RSIdHybwOfR-oHFJ8Cz3icKUp-TzAy1L3mKdu-qo7vKJfIh-KPj5ONfk9_XV7eUPdvPr-8_LixsGasNn5ryx0VgZVBdktBAs-BC1V1JvTJTaR-g0cNdtuIAYwKgI2IQojN90xnC1JueHu7s83S9Y5nbsC-Aw-ITTUtqGW2EbaypoDyDkqZSMsd3lfqxfbwVv9-G3L-G3r-G3B2VNvhzfWLoRw3_GQ9oVODsCvoAfYvYJ-vLGOSO5VOofGSCQ3g</recordid><startdate>19991001</startdate><enddate>19991001</enddate><creator>DE HERT, S. G</creator><creator>VAN DER LINDEN, P. J</creator><creator>TEN BROECKE, P. W</creator><creator>RODRIGUS, I. E</creator><creator>SERMEUS, L. A</creator><creator>MOULIJN, A. C</creator><creator>GILLEBERT, T. C</creator><general>Lippincott</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>7X8</scope></search><sort><creationdate>19991001</creationdate><title>The effects of β-adrenergic stimulation on the length-dependent regulation of myocardial function in coronary surgery patients</title><author>DE HERT, S. G ; VAN DER LINDEN, P. J ; TEN BROECKE, P. W ; RODRIGUS, I. E ; SERMEUS, L. A ; MOULIJN, A. C ; GILLEBERT, T. 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C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effects of β-adrenergic stimulation on the length-dependent regulation of myocardial function in coronary surgery patients</atitle><jtitle>Anesthesia and analgesia</jtitle><addtitle>Anesth Analg</addtitle><date>1999-10-01</date><risdate>1999</risdate><volume>89</volume><issue>4</issue><spage>835</spage><epage>842</epage><pages>835-842</pages><issn>0003-2999</issn><eissn>1526-7598</eissn><coden>AACRAT</coden><abstract>Increasing cardiac load by leg elevation identifies patients with load-dependent impairment of left ventricular (LV) function. This impairment is related to a deficient length-dependent regulation of LV function. We investigated the effects of dobutamine on length-dependent regulation of LV function in coronary surgery patients (n = 25). High-fidelity LV pressure tracings were obtained at end-expiration, while hearts were paced at a fixed rate of 90 bpm. Effects of leg elevation on contraction and relaxation were compared before and during dobutamine 5 microg x kg(-1) x min(-1). Effects on contraction were evaluated by analysis of changes in dP/dtmax. Effects on relaxation were assessed by analysis of R (slope of the relation between the time constant of isovolumic relaxation and end-systolic pressure). Correlations were calculated with linear regression analysis using Pearson's coefficient r. The effects of leg elevation on variables of contraction and relaxation were coupled. We found a close relationship between changes in dP/dtmax and individual values of R (r = 0.84; P < 0.001). Dobutamine improved myocardial function and accelerated LV pressure decrease. Under dobutamine, the increase in dP/dtmax with leg elevation was larger (P < 0.001) and load dependence of LV relaxation was reduced (P = 0.001). Dobutamine improved the effects of leg elevation on LV function, reflecting improved length-dependent regulation of LV function.
This study demonstrated that beta-adrenoreceptor stimulation with dobutamine improved length-dependent regulation of myocardial function assessed during leg elevation in cardiac surgical patients.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>10512252</pmid><doi>10.1097/00000539-199910000-00005</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adrenergic beta-Agonists - administration & dosage Adrenergic beta-Agonists - therapeutic use Aged Biological and medical sciences Cardiac Output - drug effects Cardiac Pacing, Artificial Cardiac Volume - drug effects Cardiotonic agents Cardiotonic Agents - administration & dosage Cardiotonic Agents - therapeutic use Cardiovascular system Coronary Artery Bypass Dobutamine - administration & dosage Dobutamine - therapeutic use Elective Surgical Procedures Female Heart Rate Humans Leg - physiology Linear Models Male Medical sciences Myocardial Contraction - drug effects Pharmacology. Drug treatments Posture Stroke Volume - drug effects Ventricular Function, Left - drug effects Ventricular Pressure - drug effects |
| title | The effects of β-adrenergic stimulation on the length-dependent regulation of myocardial function in coronary surgery patients |
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