Skip to main content
NCBI home page
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1977 Mar 19;116(6):645–648.

Hemodynamic and therapeutic effects of intravenous dopamine

P Théroux, HF Mizgala, MG Bourassa
PMCID: PMC1879175  PMID: 608165

Abstract

The effects of intravenous dopamine were evaluated in 10 patients with severe but stable coronary artery disease, 17 consecutive patients with primary cardiogenic shock and 3 with severe congestive heart failure and oliguria. Dopamine infusion at 10 μg/kg·min in the 10 patients increased cardiac output by 35%, left ventricular peak dP/dt by 38%, left ventricular minute work index by 44% and mean systolic ejection rate by 7% (P < 0.01); heart rate, aortic pressure, left ventricular end-diastolic pressure and tension-time index were unchanged. For oxygen, potassium and lactate, arterial and coronary sinus values, coronary arteriovenous oxygen differences and myocardial extraction were unchanged. Hemodynamically 13 of the 17 patients in shock responded favourably to dopamine infusion (0.5 to 15 μg/kg·min), with decrease in heart rate, increase in systolic arterial pressure from 75 to 100 mm Hg (P <0.001), decrease in ventricular filling pressure from 20 to 16 mm Hg (P < 0.01) and increase in urine output from 10 to 100 ml/h (P < 0.01). Eleven of those patients survived the shock episode. A close relation was observed between the hemodynamic response to dopamine, survival from the shock episode and the time between onset of shock and initiation of therapy. Low rates of dopamine infusion induced diuresis in the three patients with severe cardiac failure.

Dopamine thus seems to improve the mechanical efficiency of the heart in coronary artery disease. Cardiac output is selectively increased and myocardial ischemia does not appear to be induced; those beneficial effects as well as presumably specific action on renal flow and natriuresis, improve immediate survival from cardiogenic shock and severe heart failure.

Full text

PDF
645

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beregovich J., Bianchi C., Rubler S., Lomnitz E., Cagin N., Levitt B. Dose-related hemodynamic and renal effects of dopamine in congestive heart failure. Am Heart J. 1974 May;87(5):550–557. doi: 10.1016/0002-8703(74)90491-8. [DOI] [PubMed] [Google Scholar]
  2. Black W. L., Rolett E. L. Cardiovascular adrenergic activity of dopamine in the dog. Am Heart J. 1968 Feb;75(2):233–239. doi: 10.1016/s0002-8703(68)90068-9. [DOI] [PubMed] [Google Scholar]
  3. Crexells C., Bourassa M. G., Biron P. Effects of dopamine on myocardial metabolism in patients with ischaemic heart disease. Cardiovasc Res. 1973 Jul;7(4):438–445. doi: 10.1093/cvr/7.4.438. [DOI] [PubMed] [Google Scholar]
  4. EBLE J. N. A PROPOSED MECHANISM FOR THE DEPRESSOR EFFECT OF DOPAMINE IN THE ANESTHETIZED DOG. J Pharmacol Exp Ther. 1964 Jul;145:64–70. [PubMed] [Google Scholar]
  5. Février C., Colin L., Hanquet M. La dopamine dans le traitement du shock. Rev Med Liege. 1970 Mar 15;25(6):173–181. [PubMed] [Google Scholar]
  6. GOLDBERG L. I., MCDONALD R. H., Jr, ZIMMERMAN A. M. SODIUM DIURESIS PRODUCED BY DOPAMINE IN PATIENTS WITH CONGESTIVE HEART FAILURE. N Engl J Med. 1963 Nov 14;269:1060–1064. doi: 10.1056/NEJM196311142692003. [DOI] [PubMed] [Google Scholar]
  7. HARRISON W. H., LEVITT M., UDENFRIEND S. NOREPINEPHRINE SYNTHESIS AND RELEASE IN VIVO MEDIATED BY 3,4-DIHYDROXYPHENETHYLAMINE. J Pharmacol Exp Ther. 1963 Nov;142:157–162. [PubMed] [Google Scholar]
  8. HORWITZ D., FOX SM 3. D., GOLDBERG L. I. Effects of Dopamine in man. Circ Res. 1962 Feb;10:237–243. doi: 10.1161/01.res.10.2.237. [DOI] [PubMed] [Google Scholar]
  9. Loeb H. S., Winslow E. B., Rahimtoola S. H., Rosen K. M., Gunnar R. M. Acute hemodynamic effects of dopamine in patients with shock. Circulation. 1971 Aug;44(2):163–173. doi: 10.1161/01.cir.44.2.163. [DOI] [PubMed] [Google Scholar]
  10. MCDONALD R. H., Jr, GOLDBERG L. I., MCNAY J. L., TUTTLE E. P., Jr EFFECT OF DOPAMINE IN MAN: AUGMENTATION OF SODIUM EXCRETION, GLOMERULAR FILTRATION RATE, AND RENAL PLASMA FLOW. J Clin Invest. 1964 Jun;43:1116–1124. doi: 10.1172/JCI104996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. MacCannell K. L., McNay J. L., Meyer M. B., Goldberg L. I. Dopamine in the treatment of hypotension and shock. N Engl J Med. 1966 Dec 22;275(25):1389–1398. doi: 10.1056/NEJM196612222752501. [DOI] [PubMed] [Google Scholar]
  12. Rosenblum R., Frieden J. Intravenous dopamine in the treatment of myocardial dysfunction after open-heart surgery. Am Heart J. 1972 Jun;83(6):743–748. doi: 10.1016/0002-8703(72)90204-9. [DOI] [PubMed] [Google Scholar]
  13. Talley R. C., Goldberg L. I., Johnson C. E., McNay J. L. A hemodynamic comparison of dopamine and isoproterenol in patients in shock. Circulation. 1969 Mar;39(3):361–378. doi: 10.1161/01.cir.39.3.361. [DOI] [PubMed] [Google Scholar]
  14. Wintroub B. U., Schroeder J. S., Schroll M., Robison S. L., Harrison D. C. Hemodynamic response to dopamine in experimental myocardial infarction. Am J Physiol. 1969 Dec;217(6):1716–1720. doi: 10.1152/ajplegacy.1969.217.6.1716. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES