Published Online
on January 2, 2008

A more recent version of this article appeared on January 15, 2008

This Article Full Text (PDF) Correction (v118,pe87) All Versions of this Article: 117/2/200    most recent CIRCULATIONAHA.107.737106v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Elkayam, U. Articles by Mehra, A. Search for Related Content PubMed PubMed Citation Articles by Elkayam, U. Articles by Mehra, A. Related Collections Cardio-renal physiology/pathophysiology Congestive Related Article

Submitted on June 25, 2007
Accepted on October 31, 2007

Renal Vasodilatory Action of Dopamine in Patients With Heart Failure. Magnitude of Effect and Site of Action

Uri Elkayam MD^*, Tien M.H. Ng PharmD, Parta Hatamizadeh MD, Munir Janmohamed MD, and Anilkumar Mehra MD

From the Heart Failure Program, Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, Calif.

^* To whom correspondence should be addressed. E-mail: elkayam{at}usc.edu.

Background—A "renal dose" of dopamine is often used to increase renal blood flow; however, data on the magnitude of effect and site of action in patients with heart failure are scarce.

Methods and Results—Renal effects of intravenous dopamine (1, 2, 3, 5, and 10 µg · kg^-1 · min^-1) were evaluated in 13 patients with chronic heart failure. Renal blood flow was calculated from renal artery cross-sectional area measured with intravascular ultrasound and renal blood flow velocity-time integral measured by the intravascular Doppler technique. Cross-sectional area increased and was significantly higher than baseline (0.30±0.04 cm²) at 5 µg · kg^-1 · min^-1 (0.36±0.05 cm²) and 10 µg · kg^-1 · min^-1 (0.38±0.06 cm²). The velocity-time integral was significantly higher than baseline (22±3 cm) at doses of 3 and 5 µg · kg^-1 · min^-1 (both 31±4 cm). Renal blood flow increased, whereas renal vascular resistance decreased, reaching statistical significance at 2 µg · kg^-1 · min^-1 through 10 µg · kg^-1 · min^-1. Cardiac output gradually increased, reaching statistical significance at doses of 5 and 10 µg · kg^-1 · min^-1 (5.5±0.5 and 6.1±0.7 versus 4.5±5.2 L/min at baseline), but the increase in renal blood flow appeared proportionately larger than corresponding increases in cardiac output.

Conclusions—Dopamine is associated with an increase in renal blood flow in patients with heart failure. This effect is due to dilation of both the large conductance and small resistance renal blood vessels. Further evaluation of the efficacy and safety of dopamine for improvement of renal function in hospitalized patients with heart failure is warranted.

Key words: heart failure • kidney • inotropic agents • vasodilation • blood flow • pharmacology

Related Article:

Clinical Summaries
Circulation 2008 117: 127. [Extract] [Full Text]

This article has been cited by other articles:

				K. V. Liang, E. L. Greene, A. W. Williams, C. A. Herzog, D. O. Hodge, T. E. Owan, and M. M. Redfield Exploratory study of relationship between hospitalized heart failure patients and chronic renal replacement therapy Nephrol. Dial. Transplant., August 1, 2009; 24(8): 2518 - 2523. [Abstract] [Full Text] [PDF]

				J. McMurray, M. Petrie, K. Swedberg, M. Komajda, S. Anker, and R. Gardner CHAPTER 23 Heart Failure ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]

				U. Elkayam, M. W. Akhter, M. Liu, P. Hatamizadeh, and M. N. Barakat Assessment of renal hemodynamic effects of nesiritide in patients with heart failure using intravascular Doppler and quantitative angiography. J. Am. Coll. Cardiol. Img., November 1, 2008; 1(6): 765 - 771. [Abstract] [Full Text] [PDF]

				G. Lema, R. Canessa, and J. Urzua Letter by Lema et al Regarding Article, "Renal Vasodilatory Action of Dopamine in Patients With Heart Failure: Magnitude of Effect and Site of Action" Circulation, October 21, 2008; 118(17): e675 - e675. [Full Text] [PDF]

				U. Elkayam, T. M.H. Ng, P. Hatamizadeh, M. Janmohamed, and A. Mehra Response to Letter Regarding Article, "Renal Vasodilatory Action of Dopamine in Patients With Heart Failure: Magnitude of Effect and Site of Action" Circulation, October 21, 2008; 118(17): e676 - e676. [Full Text] [PDF]