Myocardial oxygen consumption: effects of epinephrine, isoproterenol, dopamine, norepinephrine, and dobutamine

Vasu, M.A.; O'Keefe, D.D.; Kapellakis, G.Z.; Vezeridis, M.P.; Jacobs, M.L.; Daggett, W.M.; Powell, W.J.

American Journal of Physiology 235(2): H237-H241


ISSN/ISBN: 0002-9513
PMID: 686191
Accession: 005952502

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An important consideration in the evaluation of pharmacologic agents used in low-cardiac-output states is the relative effect of these agents on myocardial oxidative demands. It is not known whether any of the catecholamines possess a relative advantage or disadvantage due to differences in myocardial O2 consumption (M.ovrhdot.VO2) in the ejecting heart, independent of differences in the hemodynamic correlates of M.ovrhdot.VO2. The M.ovrhdot.VO2 effects of epinephrine, isoproterenol, dopamine, norepinephrine and dobutamine were examined at both high- and low-dosage levels under conditions of controlled hemodynamics; the studies were performed in nonfailing canine hearts with low initial left ventricular end-diastolic pressures. In high doses, dobutamine increased M.ovrhdot.VO2 significantly more than epinephrine and isoproterenol, and epinephrine increased M.ovrhdot.VO2 more than isoproterenol, but these observations could be explained by the effects of dobutamine and epinephrine on the hemodynamic correlates of M.ovrhdot.VO2. Otherwise, for comparable changes in the hemodynamic correlates of M.ovrhdot.VO2, the changes in M.ovrhdot.VO2 were similar irrespective of the catecholamine under study. Cardiac-active catecholamines administered for inotropic support may cause similar increases in the consumption of O2 by the myocardium; thus, selection of a given catecholamine for inotropic support should include other criteria than just the direct effect of the agent on myocardial oxidative metabolism.