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Department of Integrative Physiology and Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, Texas 76107-2699
Although the
1-adrenergic agent dobutamine is used clinically to
provide inotropic support to the failing myocardium, it could
jeopardize the myocardium by depleting energy reserves. This
investigation delineated the contractile and energetic effects of low
versus high dobutamine doses in the hypoperfused right ventricular (RV)
myocardium. The right coronary artery (RCA) of anesthetized dogs was
cannulated for controlled perfusion with arterial blood, and regional
RV contractile function was measured. RCA perfusion pressure was
lowered from 100 mmHg baseline to 40 mmHg, and flow fell by 54%. At
15-min hypoperfusion, dobutamine was infused into the RCA at either
0.01 (low-dose dobutamine) or 0.06 µg · kg
1 · min
1
(high-dose dobutamine) for 15 min. Regional power (systolic segment shortening × isometric developed force × heart rate)
stabilized at 63% of baseline during hypoperfusion. Low-dose
dobutamine restored power to baseline but did not increase RV
myocardial O2 consumption (M
O2) and thus increased myocardial
O2 utilization efficiency (O2UE:power/M
O2).
At 5 min, high-dose dobutamine enhancement of power was similar to that
of low-dose dobutamine, but by 15 min, power and O2UE fell
to untreated levels. Remarkably, low-dose dobutamine tripled cytosolic
phosphorylation potential; in contrast, high-dose dobutamine lowered
phosphorylation potential to 45% of the untreated value. Analyses of
glucose uptake and glycolytic intermediates revealed sustained
enhancement of glycolysis by low-dose dobutamine, but glycolysis became
limited at glyceraldehyde 3-phosphate dehydrogenase during
high-dose dobutamine treatment. In summary, low-dose dobutamine
improved mechanical performance and efficiency of the hypoperfused RV
myocardium while increasing myocardial energy reserves, but high-dose
dobutamine failed to sustain improved function and depleted energy
reserves. Dobutamine is capable of improving both contractile function
and cellular energetics in the hypoperfused RV myocardium, but dosage
should be carefully selected.
phosphorylation potential; phosphocreatine; glycogen; glycolysis; oxygen utilization efficiency
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