© 1997 by European Society of Cardiology
Copyright © 1997, European Society of Cardiology
Targeting of dobutamine to ischemic myocardium without systemic effects by selective suction and pressure-regulated retroinfusion
Department of Internal Medicine I, Klinikum Großhadern, University of Munich, Marchioninistr. 15, 81377 Munich, Germany
* Corresponding author. Tel.: +49 (89) 70953092; fax: +49 (89) 70953064.
Objective: To study the effects of low-dose dobutamine and/or glyceryl trinitrate in addition to selective suction and pressure-regulated retroinfusion with arterial blood on regional myocardial function of the ischemic myocardium and systemic hemodynamics. Methods: Using a pig model of repeated brief (90 s) occlusions of the left anterior descending artery, selective suction and pressure-regulated retroinfusion was carried out either with arterial blood alone (SSRalone) or with arterial blood and simultaneous application of low-dose dobutamine (0.1 µg/kg/min) (SSRDOB), glyceryl trinitrate (0.03 mg/kg/min) (SSRNIT) or the combination of both drugs (SSRDOB+NIT). Regional myocardial function of the ischemic and non-ischemic myocardium was determined by sonomicrometry (segment shortening). Results: Segment shortening in the ischemic area after 90 s of ischemia was preserved at 57.5±9.2% with SSRalone but at 78.0±22.3% of baseline with SSRDOB (P<0.05). The addition of glyceryl trinitrate did not improve regional myocardial function further. No effects of locally applied dobutamine were observed with regard to non-ischemic myocardium or heart rate. Cardiac output and mean arterial blood pressures tended to be further stabilized with SSRDOB. Conclusions: Local application of low-dose dobutamine together with arterial blood by selective suction and pressure-regulated retroinfusion during brief myocardial ischemia resulted in improved regional myocardial function without undesired effects on non-ischemic myocardium or systemic hemodynamics.
KEYWORDS Retroinfusion; Myocardial ischemia; Dobutamine; Nitrates; Hibernation; Pig, anesthetized
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