Dopexamine increases internal mammary artery blood flow following coronary artery bypass grafting.

Hdl Handle:
http://hdl.handle.net/10147/208981
Title:
Dopexamine increases internal mammary artery blood flow following coronary artery bypass grafting.
Authors:
Flynn, Michael J; Winter, Desmond C; Breen, Patrick; O'Sullivan, Gerry; Shorten, George; O'Connell, Damien; O'Donnell, Aonghus; Aherne, Thomas
Affiliation:
Department of Cardiothoracic Surgery, Cork University Hospital, Wilton, Cork,, Ireland. barradrum@hotmail.com
Citation:
Eur J Cardiothorac Surg. 2003 Oct;24(4):547-51.
Journal:
European journal of cardio-thoracic surgery : official journal of the European, Association for Cardio-thoracic Surgery
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/208981
PubMed ID:
14500073
Abstract:
OBJECTIVE: Vasoactive agents and inotropes influence conduit-coronary blood flow following coronary artery bypass grafting (CABG). It was hypothesized that dopexamine hydrochloride, a dopamine A-1 (DA-1) and beta(2) agonist would increase conduit-coronary blood flow. A prospective randomized double blind clinical trial was carried out to test this hypothesis. DA-1 receptors have previously been localized to human left ventricle. METHODS: Twenty-six American Society of Anaesthesiology class 2-3 elective coronary artery bypass graft patients who did not require inotropic support on separation from cardiopulmonary bypass (CPB) were studied. According to a randomized allocation patients received either dopexamine (1 microg/kg per min) or placebo (saline) by intravenous infusion for 15 min. Immediately prior to and at 5,10 and 15 min of infusion, blood flow through the internal mammary and vein grafts (Transit time flow probes, Transonic Ltd.), heart rate, cardiac index, mean arterial pressure and pulmonary haemodynamics were noted. The data were analysed using multivariate analysis of variance. RESULTS: Low-dose dopexamine (1 microg/kg per min) caused a significant increase in mammary graft blood flow compared to placebo at 15 min of infusion (P=0.028, dopexamine group left internal mammary artery (LIMA) flow of 43.3+/-14.2 ml/min, placebo group LIMA flow at 26.1+/-16.3 ml/min). Dopexamine recipients demonstrated a non-significant trend to increased saphenous vein graft flow (P=0.059). Increased heart rate was the only haemodynamic change induced by dopexamine (P=0.004, dopexamine group at 85.2+/-9.6 beats/min and placebo group at 71.1+/-7.6 beats/min after 15 min of infusion). CONCLUSION: This study demonstrates that administration of dopexamine (1 microg/kg per min) was associated with a significant increase in internal mammary artery graft blood flow with mild increase in heart rate being the only haemodynamic change. Low-dose dopexamine may improve graft flow in the early post CABG period with minimal haemodynamic changes.
Language:
eng
MeSH:
Adrenergic beta-Agonists/pharmacology; Aged; *Coronary Artery Bypass; Coronary Circulation/*drug effects; Dopamine/*analogs & derivatives/*pharmacology; Dopamine Agonists/pharmacology; Double-Blind Method; Female; Hemodynamics/drug effects; Humans; Male; Mammary Arteries/*drug effects/physiopathology/transplantation; Middle Aged; Multivariate Analysis; Postoperative Care/methods; Prospective Studies; Vasodilator Agents/*pharmacology
ISSN:
1010-7940 (Print); 1010-7940 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorFlynn, Michael Jen_GB
dc.contributor.authorWinter, Desmond Cen_GB
dc.contributor.authorBreen, Patricken_GB
dc.contributor.authorO'Sullivan, Gerryen_GB
dc.contributor.authorShorten, Georgeen_GB
dc.contributor.authorO'Connell, Damienen_GB
dc.contributor.authorO'Donnell, Aonghusen_GB
dc.contributor.authorAherne, Thomasen_GB
dc.date.accessioned2012-02-03T15:09:05Z-
dc.date.available2012-02-03T15:09:05Z-
dc.date.issued2012-02-03T15:09:05Z-
dc.identifier.citationEur J Cardiothorac Surg. 2003 Oct;24(4):547-51.en_GB
dc.identifier.issn1010-7940 (Print)en_GB
dc.identifier.issn1010-7940 (Linking)en_GB
dc.identifier.pmid14500073en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208981-
dc.description.abstractOBJECTIVE: Vasoactive agents and inotropes influence conduit-coronary blood flow following coronary artery bypass grafting (CABG). It was hypothesized that dopexamine hydrochloride, a dopamine A-1 (DA-1) and beta(2) agonist would increase conduit-coronary blood flow. A prospective randomized double blind clinical trial was carried out to test this hypothesis. DA-1 receptors have previously been localized to human left ventricle. METHODS: Twenty-six American Society of Anaesthesiology class 2-3 elective coronary artery bypass graft patients who did not require inotropic support on separation from cardiopulmonary bypass (CPB) were studied. According to a randomized allocation patients received either dopexamine (1 microg/kg per min) or placebo (saline) by intravenous infusion for 15 min. Immediately prior to and at 5,10 and 15 min of infusion, blood flow through the internal mammary and vein grafts (Transit time flow probes, Transonic Ltd.), heart rate, cardiac index, mean arterial pressure and pulmonary haemodynamics were noted. The data were analysed using multivariate analysis of variance. RESULTS: Low-dose dopexamine (1 microg/kg per min) caused a significant increase in mammary graft blood flow compared to placebo at 15 min of infusion (P=0.028, dopexamine group left internal mammary artery (LIMA) flow of 43.3+/-14.2 ml/min, placebo group LIMA flow at 26.1+/-16.3 ml/min). Dopexamine recipients demonstrated a non-significant trend to increased saphenous vein graft flow (P=0.059). Increased heart rate was the only haemodynamic change induced by dopexamine (P=0.004, dopexamine group at 85.2+/-9.6 beats/min and placebo group at 71.1+/-7.6 beats/min after 15 min of infusion). CONCLUSION: This study demonstrates that administration of dopexamine (1 microg/kg per min) was associated with a significant increase in internal mammary artery graft blood flow with mild increase in heart rate being the only haemodynamic change. Low-dose dopexamine may improve graft flow in the early post CABG period with minimal haemodynamic changes.en_GB
dc.language.isoengen_GB
dc.subject.meshAdrenergic beta-Agonists/pharmacologyen_GB
dc.subject.meshAgeden_GB
dc.subject.mesh*Coronary Artery Bypassen_GB
dc.subject.meshCoronary Circulation/*drug effectsen_GB
dc.subject.meshDopamine/*analogs & derivatives/*pharmacologyen_GB
dc.subject.meshDopamine Agonists/pharmacologyen_GB
dc.subject.meshDouble-Blind Methoden_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHemodynamics/drug effectsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMammary Arteries/*drug effects/physiopathology/transplantationen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMultivariate Analysisen_GB
dc.subject.meshPostoperative Care/methodsen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshVasodilator Agents/*pharmacologyen_GB
dc.titleDopexamine increases internal mammary artery blood flow following coronary artery bypass grafting.en_GB
dc.contributor.departmentDepartment of Cardiothoracic Surgery, Cork University Hospital, Wilton, Cork,, Ireland. barradrum@hotmail.comen_GB
dc.identifier.journalEuropean journal of cardio-thoracic surgery : official journal of the European, Association for Cardio-thoracic Surgeryen_GB
dc.description.provinceMunster-

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