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(Circulation. 1998;98:126-131.)
© 1998 American Heart Association, Inc.

Clinical Investigation and Reports

Dopamine Depresses Minute Ventilation in Patients With Heart Failure

Philippe van de Borne, MD, PhD; Ron Oren, MD; ; Virend K. Somers, MD, PhD

From the Cardiovascular Division, Department of Internal Medicine and the Cardiovascular Center, University of Iowa Hospitals and Clinics, Iowa City.

Correspondence to Virend K. Somers, MD, PhD, Cardiovascular Division, Department of Internal Medicine, University of Iowa College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242. E-mail virend-somers{at}uiowa.edu

Background—Low-dose dopamine is frequently used in patients in the intensive care setting. Dopamine may inhibit chemoreceptor afferents and hence decrease chemoreflex sensitivity to hypoxia.

Methods and Results—In a double-blind, randomized, crossover study, we determined the effects of dopamine (5 µg · kg^-1 · min^-1) and placebo infusion on oxygen saturation, minute ventilation, and sympathetic nerve activity during normoxia and 5 minutes of hypoxia in 10 normal young subjects. We further investigated the effects of dopamine and placebo on minute ventilation during normoxic breathing in 8 patients with severe heart failure and in 8 age-matched control subjects. Dopamine did not decrease minute ventilation during normoxia in normal subjects. During hypoxia, minute ventilation was 12.9±1.3 L/min on dopamine and 15.8±1.5 L/min on placebo (P<0.0001). Oxygen saturation during hypoxia was lower with dopamine (78±3%) than placebo (84±2%; P<0.0001). Sympathetic nerve activity during hypoxia was not enhanced with dopamine despite the lower O₂ saturation. Subjects were able to maintain a voluntary apnea to a lower oxygen saturation on dopamine than on placebo (P<0.05). In heart failure patients breathing room air, but not in age-matched control subjects, dopamine decreased minute ventilation despite decreased oxygen saturation and increased PETCO₂ during dopamine (all P0.02).

Conclusions—Dopamine inhibits chemoreflex responses during hypoxic breathing in normal humans, preferentially affecting the ventilatory response more than the sympathetic response. Dopamine also depresses ventilation in normoxic heart failure patients breathing room air. Ventilatory inhibition by low-dose dopamine may adversely influence outcome in hypoxic patients, especially in patients with heart failure.

Key Words: ventilation • dopamine • heart failure • nervous system, sympathetic

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