EFFECT OF DOBUTAMINE AND OPC-18790 ON DIASTOLIC CHAMBER STIFFNESS IN PATIENTS WITH IDIOPATHIC DILATED CARDIOMYOPATHY

Citation
T. Machii et al., EFFECT OF DOBUTAMINE AND OPC-18790 ON DIASTOLIC CHAMBER STIFFNESS IN PATIENTS WITH IDIOPATHIC DILATED CARDIOMYOPATHY, Journal of cardiovascular pharmacology, 29(2), 1997, pp. 265-272
Citations number
37
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System","Pharmacology & Pharmacy
ISSN journal
0160-2446
Volume
29
Issue
2
Year of publication
1997
Pages
265 - 272
Database
ISI
SICI code
0160-2446(1997)29:2<265:EODAOO>2.0.ZU;2-#
Abstract
We investigated the acute effects of the positive inotropic agents (do butamine and a novel phosphodiesterase inhibitor OPC-18790) on left ve ntricular diastolic chamber stiffness in patients with idiopathic dila ted cardiomyopathy (DCM). We obtained pressure-volume (PV) data before and after drug administration in 17 patients with DCM by using a cond uctance catheter with a micromanometer tip. Patients were randomly ass igned to receive intravenous infusions of dobutamine (2.5-7.5 mu g/kg body weight per min, n = 8) or OPC-18790 (5-10 mu g/kg body weight per min, n = 9). The dynamic diastolic chamber stiffness constant was cal culated from a steady-state beat. The passive diastolic chamber stiffn ess constant was determined from the end-diastolic PV relation determi ned during transient inferior vena caval occlusion. Dobutamine and OPC -18790 similarly improved left ventricular end-systolic elastance (E(e s)) and left ventricular isovolumic relaxation time constants. The dyn amic diastolic chamber stiffness constant decreased significantly in b oth the dobutamine (0.0934 +/- 0.0271 to 0.0685 +/- 0.0248; p < 0.01) and OPC-18790 (0.0843 +/- 0.0477 to 0.0569 +/- 0.0246; p < 0.05) group s. The passive diastolic chamber stiffness constant decreased signific antly in the OPC-18790-treated group (0.0211 +/- 0.0114 to 0.0144 +/- 0.0117; p < 0.005) but not in the dobutamine-treated group (0.0197 +/- 0.0130 to 0.0186 +/- 0.0102; p > 0.05). Thus both dobutamine and OPC- 18790 reduced the dynamic diastolic chamber stiffness constant, but on ly OPC-18790 reduced the passive diastolic chamber stiffness constant. OPC-18790 had a favorable effect on diastolic function in patients wi th DCM, compared with that of dobutamine. The passive diastolic chambe r stiffness obtained from the end-diastolic PV relations represents mo re likely passive chamber properties than the dynamic diastolic chambe r stiffness obtained from traditional single-beat analysis.