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• W2088220500 abstract "Abstract The purpose of this study was twofold. First, we wished to determine if right ventricular ischemia initiates the development of a decrease in cardiac output during acute pulmonary hypertension and, second, we wished to determine the hemodynamic and metabolic effects of dobutamine once the decreased cardiac output state had occurred. Six open chest and open pericardium dogs were studied after instrumentation with right and left ventricular (RV and LV, respectively), and pulmonary artery (PA) Millar catheters, a PA thermodilution catheter, and RV and LV segment length crystals. Measurements were taken before and after the administration of sufficient glass bead emboli to first triple the PA pressure and then to decrease the cardiac output by approximately 20% compared with the cardiac output in the preceding condition. Measurements were repeated after infusing dobutamine at 5 μg/kg/min for 20 minutes and then at 10 μg/kg/min for 20 minutes. In addition to hemodynamic measurements, RV tissue biopsies were obtained for adenosine triphosphate (ATP) and creatine phosphate (CP) determinations at each stage. Our results demonstrated that the occurrence of a modest decrease in cardiac output during acute pulmonary hypertension was not associated with any decrease in either ATP or CP level. Low-dose dobutamine increased cardiac output by increasing heart rate and stroke volume. Higher dose dobutamine decreased both RV preload and afterload which culminated in a reduction in cardiac output in four of the six animals; however, mean cardiac output actually increased. Neither dose range affected RV ATP or CP. We conclude that reduced cardiac output during pulmonary hypertension is secondary to RV afterload mismatch, not ischemia. Low-dose dobutamine can increase cardiac output by increasing stroke volume and chronotropic effects. Although high-dose dobutamine can increase cardiac output further, it also has significant effects on RV preload and afterload which are potentially deleterious." @default.
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• W2088220500 date "1989-12-01" @default.
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• W2088220500 title "Right ventricular afterload mismatch during acute pulmonary hypertension and its treatment with dobutamine: A pressure segment length analysis in a canine model" @default.
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• W2088220500 doi "https://doi.org/10.1016/0883-9441(89)90064-6" @default.
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