Skip to main content
SpringerLink
Log in

Treatment of acute left heart failure using dobutamine and intraaortic counterpulsation

Animal experiments and first clinical experiences

  • Original Articles
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Ten anesthetized mongrel dogs had a left anterolateral thoracotomy; the left anterior descending coronary artery was then ligated. After 60 min five animals each were treated either with dobutamine (4 μg/min/kg; for 10 min), or with dobutamine and intraaortic counterpulsation. Combined treatment of cardiogenic shock proved superior. Those five dogs had significantly lower heart rates and dp/dt/pvalues. Due to IABP the non-ischemic parts of the left ventricle were better perfused; there was no difference in treatment with regard to ischemic parts. The combined treatment was successfully inaugurated in two patients with cardiogenic shock.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Becker LC, Ferreira R, Thomas M (1973) Mapping of left ventricular bloodflow with radioactive microspheres in experimental coronary artery occlusion. Cardiovasc Res 7:391

    Google Scholar 

  2. Bregman D, Kripke DC, Goetz RH (1970) Effect of synchronous unidirectional IABP on hemodynamics and coronary blood flow in cardiogenic shock. Trans Amer Soc Artif Int Organs 16:439

    Google Scholar 

  3. Buckberg GD, Ross G (1973) Effects of isoprenaline on coronary blood flow: its distribution and myocardial performance. Cardiovascular Res 7:429

    Google Scholar 

  4. Buckberg GD (1975) Studies of regional coronary flow using radioactive microspheres. Ann Thor Surg 26:46

    Google Scholar 

  5. Cobb RR, Bache FJ, Greenfield JC (1974) Regional myocardial blood flow in awake dogs. J Clin Invest 53:1618

    Google Scholar 

  6. Laria GA de, Johansen KH, Sobel BE, Sybers HD, Bernstein EF (1974) Delayed evolution of myocardial ischemic injury after IABP. Circ 49/50 Suppl II II:242

    Google Scholar 

  7. Vivie ER de (1976) Intraaortale Gegenpulsation. Springer, Berlin Heidelberg New York

    Google Scholar 

  8. Feola M, Adacki M, Akers WW, Ross JN, Wieting DW, Kennedy JH (1971) IABP in the experimental animal. Am J Cardiol 27:129

    Google Scholar 

  9. Feola M, Haiderer O, Kennedy JH (1971) IABP at different levels of experimental acute left ventricular failure. Chest 59:68

    Google Scholar 

  10. Flameng W, Wüsten B, Winkler B, Pasyk S, Schaper W, Carl M (1975) Influence of perfusion pressure and heart rate on local myocardial flow in the collateralized heart with chronic coronary occlusion. Am Heart J 89:51

    Google Scholar 

  11. Forrester JS, Luz PL da, Chattejee K (1975) Peripheral vasodilators in low cardiac output states. Surg Clinics of North America 55:531

    Google Scholar 

  12. Fortuin NJ, Kaihara S, Becker IC, Pitt B (1971) Regional myocardial blood flow in the dog. Studied with radioactive microspheres. Cardiovasc Res 5:331

    Google Scholar 

  13. Goldberg LI (1972) Cardiovascular and renal actions of dopamine: potential clinical applications. Pharmacol Rev 24:1

    Google Scholar 

  14. Goldberg LI, Hsiek K, Resnekov L (1977) Newer catecholamines for treatment of heart failure and shock: an update on dopamine and a first look at dobutamine. Prog Card Vasc Dis 29:327

    Google Scholar 

  15. Gunnar RM, Loeb HS (1972) Use of drugs in cardiogenic shock due to acute myocardial infarction. Circ 45:1111

    Google Scholar 

  16. Hess DS, Bache RJ (1976) Transmural distribution of myocardial blood flow during systole in the awake dog. Circ Res 38:5

    Google Scholar 

  17. Hess W, Brückner JB, Schmidt D, Schweichel E, Tarnow J (1977) Ein Vergleich der kardiovaskuläre Wirkungen von Dobutamind und Dopamin. Z Kardiol 66:537

    Google Scholar 

  18. Holloway GA, Fredrickson EL (1974) Dobutamine, a new beta agonist. Anesth Analg 53:616

    Google Scholar 

  19. Irnich W, Bleifeld W, Meyer-Hatwig K, Bisping HJ (1972) Die physiologischen und technischen Grundlagen der Ballonpulsationsmethode. Zschr Kreislaufforschung 61:339

    Google Scholar 

  20. Leinbach RC, Buckley MJ, Austen WG, Petschek HE, Kantrowitz AR, Sanders CA (1971) Effects of intraaortic balloon pumping on coronary flow and metabolism in man. Circ 48/49 Suppl I I:77

    Google Scholar 

  21. Maroko PR, Kjekshus JK, Sobel BE, Watanabe T, Covell JW, Ross J, Braunwald F (1971) Factors influencing infarct size following experimental coronary artery occlusions. Circ 43:67

    Google Scholar 

  22. Maroko PR, Bernstein EF, Libby P, Lavia G de, Covell JW, Ross J, Braunwald E (1972) Effects of IABP on severity of myocardial ischemic injury following acute coronary occlusion. Circ 45:1150

    Google Scholar 

  23. Mason DT (1979) Afterload reduction and cardiac performance. Am J Med 65:106

    Google Scholar 

  24. Michels R, Kint PP, Hagemeijer F, Brand M vd, Serruys PW, Hugenholtz PG (1979) Intra-aortic balloon pumping in coronary artery disease. Herz 4:397

    Google Scholar 

  25. Miller RR, Vismara LA, Williams DO, Salel AF, Odom R, Mason DT (1975) Effects of ventricular unloading by nitroprusside on myocardial energetics and coronary blood flow in patients with ischemic heart disease. Circ 51 52 Suppl II II:217

    Google Scholar 

  26. Morales AR, Fine G, Taber RE (1967) Cardiac surgery and myocardial necrosis. Arch Path 83:71

    Google Scholar 

  27. Mueller H, Ayres S, Conklin EF, Gianelli S, Mazzara JT, Grace WT, Nealon TF (1971) The effects of intra-aortic counterpulsation on cardiac performance and metabolism in shock assiaciated with acute myocardial infarction. J Clin Lab 50:1885

    Google Scholar 

  28. Mueller H, Ayres SM, Gianelli S, Conklin EF, Mazzara JT, Grace WJ (1972) Effect of Isoproterenol, 1-Norepinephrine and intraaortic counterpulsation on hemodynamics and myocardial metabolism in shock following acute myocardial infarction. Circulation 45:335

    Google Scholar 

  29. Najafi H, Henson D, Dye WS, Javid H, Hunter JA, Callghan R, Eisenstein, Julian OC (1969) Left ventricular hemorrhagic necrosis. Ann Thor S 7 7:550

    Google Scholar 

  30. Neill WA, Phelps NC, Oxendrine JM, Mahler DJ, Sim DN (1973) Effect of heart rate on coronary blood flow distribution in dog. Am J Cardiol 32:306

    Google Scholar 

  31. Powell WJ, Daggett WM, Magro AE, Bianco JA, Buckley MJ, Sanders CA, Kantrowitz AR, Austen WG (1970) Effects of IABP on cardiac performance, oxygen consumption and coronary blood flow in dogs. Circulat Res 26:753

    Google Scholar 

  32. Reichart B (1978) Behandlungsmöglichkeiten des akuten Rechtsherzversagens. Fortschritte der Medizin 96:2260

    Google Scholar 

  33. Reichart B, Kemkes BM, Kreuzer E, Klinner W (1980) Intraaortale Gegenpulsation im peri- und postoperativen Verlauf von kardiochirurgischen Eingriffen; 3-jähriger Erfahrungsbericht. Klin Wochenschr 58:631

    Google Scholar 

  34. Roberts WC, Morrow AG (1967) Causes of early postoperative death following cardiac valve replacement. J Thor Card Vasc 54:422

    Google Scholar 

  35. Robie NW, Nutter DO, Moodly C, Mc Nay LJ (1974) In vivo analysis of adrenergic receptor activity of Dobutamine. Circ Res 34:663

    Google Scholar 

  36. Rudolph AM, Heyman MA (1967) The circulation of the fetus in utero. Circ Res 21:163

    Google Scholar 

  37. Sugg WL, Webb WR, Ecker RA (1969) Reduction of extent of myocardial infarction by counterpulsation. Ann Thor 7:310

    Google Scholar 

  38. Talpins NL, Kripke DC, Yellin E, Geotz RH (1968) Hemodynamics and coronary blood flow during IABP. Surg Forum 19:122

    Google Scholar 

  39. Tuttle RR, Mills J (1975) Dobutamine Circ Res 36:185

    Google Scholar 

  40. Tuttle RR, Mills J (1975) Development of a new catecholamine to selectively increase cardiac contractility. Circ Res 36:185

    Google Scholar 

  41. Tuttle RR (1968) Beta-selectivity of Dobutamine and its potential for cardiovascular therapy. Anaesthesiol Intensivmed 118:61

    Google Scholar 

  42. Vatner SF, Mc Ritchie RJ, Braunwald E (1974) Effects of Dobutamine on left ventricular performance, coronary dynamics, and distribution of cardiac output in conscious dogs. J Clin Investig 53:1265

    Google Scholar 

  43. Wüsten B, Flameng W, Schaper W (1974) The distribution of myocardial flow, part I: effects of experimental coronary occlusion. Basic Res Cardiol 69:422

    Google Scholar 

  44. Yahr WZ, Butner AN, Krakauer JS, Tomecek J, Tjønneland S, Kantrowitz A (1968) Cardiogenic shock: dynamics of coronary blood flow with intra-aortic phase shift balloon pumping, Surg Forum 22:142

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiac Surgery, University of Munich, Federal Republic of Germany

    B. Reichart, R. Türk, E. Alt, B. Kemkes & E. Kreuzer

  2. Department of Physiology, University of Munich, Federal Republic of Germany

    J. Holtz

  3. Department of Anesthesiology, University of Munich, Federal Republic of Germany

    N. Franke & P. Schmucker

Authors
  1. B. Reichart
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Türk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Alt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. Kemkes
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. Kreuzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Holtz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. N. Franke
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. P. Schmucker
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reichart, B., Türk, R., Alt, E. et al. Treatment of acute left heart failure using dobutamine and intraaortic counterpulsation. Intensive Care Med 7, 133–138 (1981). https://doi.org/10.1007/BF01738616

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01738616

Key words

Search

Navigation