Acute haemodynamic and metabolic effects of dopexamine, a new dopaminergic receptor agonist, in patients with chronic heart failure

• Published in: British Heart Journal Vol. 54; no. 3; pp. 313 - 320
• Main Authors: Dawson, J R, Thompson, D S, Signy, M, Juul, S M, Turnbull, P, Jenkins, B S, Webb-Peploe, M M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01-09-1985; BMJ; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Biological and medical sciences; Blood Flow Velocity - drug effects; Cardiotonic agents; Cardiovascular system; Chemical Phenomena; Chemistry; Dopamine - administration & dosage; Dopamine - analogs & derivatives; Dopamine - metabolism; Dopamine - therapeutic use; Dose-Response Relationship, Drug; Female; Heart Failure - drug therapy; Heart Rate - drug effects; Hemodynamics - drug effects; Humans; Male; Medical sciences; Middle Aged; Myocardial Contraction - drug effects; Pharmacology. Drug treatments; Stroke Volume - drug effects; Vascular Resistance - drug effects; Human; Heart failure; Chemotherapy; Heart disease; Dopamine agonist; Cardiovascular disease; Hemodynamics; Metabolism
• ISSN: 0007-0769; 1468-201X; 2053-5864
• DOI: 10.1136/hrt.54.3.313

Dopexamine, a new compound with postjunctional dopamine receptor activating and beta adrenoceptor agonist properties, was given to 10 patients with chronic heart failure at diagnostic cardiac catheterisation to investigate its acute haemodynamic and metabolic effects. The drug was administered by intravenous infusion in three incremental doses and produced significant dose related increases in cardiac index, stroke volume index, and heart rate and falls in systemic vascular resistance and left ventricular end diastolic pressure; aortic and pulmonary artery pressures were unchanged. Isovolumic phase (max dP/dt and KVmax) and ejection phase (peak aortic blood velocity, maximum acceleration of blood, and maximum rate of change of power with time during ejection) indices of myocardial contractility were all increased by dopexamine but these changes were hard to interpret in the presence of an increase in heart rate. Myocardial efficiency and ejection fraction were both increased and left ventricular end diastolic and end systolic volumes fell. These largely beneficial changes were achieved without a statistically significant increase in myocardial oxygen consumption or disturbance of myocardial metabolic function. Dopexamine was well tolerated but tremor was reported by two patients at the intermediate dose and mild chest pain by two patients at the high dose.