(Circulation. 2001;103:826.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Vitamin C Augments the Inotropic Response to Dobutamine in Humans With Normal Left Ventricular Function
From Bayer Cardiovascular Clinical Research Laboratory, Division of Cardiology, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Correspondence to Gary E. Newton, MD, Division of Cardiology, Mount Sinai Hospital, 600 University Ave, Room 1604, Toronto, Ontario, Canada M5G 1X5. E-mail gary.newton{at}utoronto.ca
Background—We studied the effect of an antioxidant, the intracoronary infusion of vitamin C, on basal and dobutamine-stimulated left ventricular (LV) contractility.
Methods and Results—Nineteen patients with normal ventricular function participated in this study. A micromanometer-tipped catheter was inserted into the LV. In the experimental group (n=10), an infusion catheter was positioned in the left main coronary artery. LV peak +dP/dt (LV +dP/dt) was measured in response to the intravenous infusion of dobutamine before (Dob) and during (Dob+vit C) the intracoronary infusion of vitamin C. The intracoronary infusion of vitamin C had no effect on basal LV +dP/dt or any other hemodynamic parameter. The infusion of vitamin C augmented the LV +dP/dt response to dobutamine by 22±4% (Dob, 1680±76 mm Hg/s; Dob+vit C, 1814±97 mm Hg/s, P<0.01). In the control group (n=9), LV +dP/dt was measured in response to sequential infusions of dobutamine (Dob, Dob-2) given at the same time intervals as in the experimental group but without the intracoronary infusion of vitamin C. In contrast to the experimental group, no difference in LV +dP/dt was observed between the 2 infusions of dobutamine (Dob, 1706±131 mm Hg/s; Dob-2, 1709±138 mm Hg/s, P=NS).
Conclusions—The administration of the antioxidant vitamin C augments the inotropic response to dobutamine in humans. This suggests that redox environment contributes to the adrenergic regulation of ventricular contractility.
Key Words: antioxidants • contractility • receptors, adrenergic, beta
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