Simultaneous infusion of dopamine and nitroprusside in congestive heart failure patients decreased LVEDP to 15.7 mm Hg and increased cardiac index to 3.52 L/min/m2 (P<0.01 for both).
Does combined dopamine and nitroprusside therapy improve hemodynamic variables in patients with chronic congestive heart failure?
Combined dopamine and nitroprusside therapy significantly improves cardiac index and reduces left ventricular end-diastolic pressure in severe congestive heart failure compared to either agent alone.
p-value: p=<0.01
The hemodynamic benefits of combining administration of dopamine with nitroprusside (NP) were evaluated in nine patients with chronic congestive heart failure due to ischemic, idiopathic myocardial or valvular cardiac disease. NP alone (68 microng/min) produced decline in left ventricular end-diastolic pressure (LVEDP) from 25.4 to 14.1 mm Hg (p less than 0.01) but modest increase in cardiac index (CI) from 2.41 to 3.02 L/min/m2 (P less than 0.05). Dopamine alone (6 microng/kg/min) caused an elevation of CI to 3.36 (P less than 0.01) but without decrease of LVEDP. Simultaneous infusion of the two agents resulted in favorable alterations in both hemodynamic variables: LVEDP decreased to 15.7 (P less than 0.01) and CI increased to 3.52 (P less than 0.01). It is concluded that dopamine substantially enhances the effectiveness of nitroprusside therapy in congestive heart failure by providing concomitantly the principal beneficial actions of the vasodilator and dopamine used separately. Thus combined dopamine with NP treatment considerably raises low CI while markedly reducing elevated LVEDP and provides a potentially efficacious pharmacologic modality for the treatment of severe congestive heart failure due to left ventricular dysfunction.
Miller et al. (1977) studied chronic congestive heart failure (n=9). Combined dopamine and nitroprusside vs. nitroprusside alone and dopamine alone was evaluated on Hemodynamic variables (left ventricular end-diastolic pressure and cardiac index) (p=<0.01). Simultaneous infusion of dopamine and nitroprusside in congestive heart failure patients decreased LVEDP to 15.7 mm Hg and increased cardiac index to 3.52 L/min/m2 (P<0.01 for both).