Effects of dibutyryl cyclic AMP on coronary flow and cardiac metabolism in ischemic heart disease Kiminari Kobayashi 1 , Toshio Sano 1 , Hiroshi Yoshimura 1 , Takashi Ohta 1 , Tei Hakuta 1 , Yoshihiro Kaneko 1 1The Second Department of Internal Medicine, Yokohama University School of Medicine pp.1065-1070
Published Date 1987/10/15
DOI https://doi.org/10.11477/mf.1404205133
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The hemodynamic, coronary sinus flow and car-diac metabolic effects of dibutyryl cyclic AMP (DBcAMP) were studied in 12 patients with ischemic heart disease. DBcAMP was administered intrave-nously at a rate of 0.05/mg/kg for 30 minutes. Arterial blood pressure was significantly decreased during drug infusion associated with a reduction in total peripheral resistance. DBcAMP produced significant increases in heart rate, cardiac output and stroke volume, whereas, pressure rate product remained unchanged. Pulmonary artery pressure was also significantly decreaed. Coronary sinus flow (CSF) was markedly increased from 95±9 (SE) to142±13 ml/min (p<0. 001). Myocardial oxygen cos-umption (CVO2) was also increased significantly from 11.5±1.5 to 13.2±1.5 mg/min (p>0.05), however, the percent increase in CSF was much greater than that of CVO2 (53.2±10.2 vs 19.1±6.9). DBcAMP caused on change in myocardial lactate extraction ratio. Myocardial norepinephrine release was slightly but significantly increased from 37.5±15 15 to 62 ±18 pg/ml (p<0.05).

DBcAMP produces reductions in both preload and afterload. Slight increase in heart rate seems to be related to the reflex increase in myocardial sympa-thetic activation. Although CVO2 was slightly incre-ased, marked increase in CSF may be resulted from the direct coronary vasodilating effect of this agent. Our data suggest that DBcAMP seems to have bene-ficial effects on heart failure in patients with ische-mic heart disease.

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