Assessment of Ventricular Function in Infants and Children: Response to Dobutamine Infusion
Assessment of Ventricular Function in Infants and Children: Response to Dobutamine Infusion
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婴儿和儿童心室功能评估：多巴酚丁胺输注的反应
DOI：
10.1097/00003072-199008000-00007
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发表时间：
1990
影响因子：
10.6
通讯作者：
D. Girod
中科院分区：
文献类型：
--
作者：
R. Hurwitz;A. Siddiqui;R. Caldwell;R. Weetman;D. Girod
评价了一种评估不能进行动态运动的婴幼儿的心功能储备的方法。静息和静注多巴酚丁胺(5~15µg/kg/min)时，用核素心血管造影术测定左心室射血分数。注意到的唯一副作用是两名患者出现心律失常，他们之前有过类似的异位记录。左心室射血分数从0.40±0.21增加到最大值0.49±0.24(P<；0.001)。左心室射血分数在5µg/kg/min时(0.44±0.23)与多巴酚丁胺10µg/kg/min时(0.48±0.24)无显著差异。接受蒽环类药物治疗的6名患者静息时功能相对较低，多巴酚丁胺治疗时功能增强，继续接受抗癌治疗，病情没有恶化。在特发性扩张型心肌病或结构异常的患者中，左心室射血分数绝对值与预后的相关性最好；左心室射血分数从未超过0.40的10名患者中有6名已死亡或正在接受移植。因此，在多巴酚丁胺输注期间，左心功能的研究可以很容易地进行，从而产生有价值的预后信息。
A method to assess ventricular functional reserve in infants and children unable to perform dynamic exercise was evaluated. Left ventricular ejection fraction was measured by radionuclide angiocardiography at rest and during infusion of dobutamine in 5-15 µg/kg/min dosages. The only side effects noted were arrhythmias in two patients, who had similar ectopy documented previously. Group left ventricular ejection fraction increased from 0.40 ± 0.21 to a maximum of 0.49 ± 0.24 (P<0.001). Left ventricular ejection fraction at 5 µg/kg/min (0.44 ± 0.23) was not statistically different from that measured during infusion of dobutamine at 10 µg/kg/min (0.48 ± 0.24). The six patients receiving anthracyclines, who had relatively low function at rest and increased function during dobutamine administration, were continued on their anticancer regimen without deteriorating in condition. Absolute values of left ventricular ejection fraction correlated best with the prognosis in patients with idiopathic dilated cardiomyopathy or structural abnormalities; six out of ten patients whose left ventricular ejection fraction never rose above 0.40 have either died or are in transplant protocols. Thus, study of left ventricular function can be performed easily during dobutamine infusion, generating valuable prognostic information.