Abstract 16551: Throttle and Brake - A Novel Therapeutic Strategy in Post-Ischemic Acute Heart Failure by Combined Use of Dobutamine and Ivabradine
Introduction: Compensatory tachycardia can potentially be deleterious in ischemic and post ischemic acute heart failure. We tested a therapeutic strategy by combining inotropic support and slowing the sinus node using ivabradine.
Methods: In an open-chest pig model (n=12) with left ventricular (LV) ischemic reperfusion injury, cardiac performance was assessed by LV pressure catheter and sonometric crystals for LV volumetry. Coronary flow probes and blood samples from the coronary sinus supplied data for myocardial oxygen combustion (MVO2).
Results: Dobutamine (5 ug/kg/min) restored cardiac output in the post ischemic heart by increasing heart rate from 102 ± 21 to 131±16 bpm. Adding ivabradine (0.5 mg/kg) to dobutamine-support slowed heart rate back to 100 ± 9 bpm and increased stroke volume (SV) from 29 ± 5 to 35 ± 3 ml while maintaining cardiac output (CO) and mean arterial pressure (MAP).
Ivabradine had a neutral effect on post ischemic LV energetics compared to dobutamine alone at a wide range of workloads.
Conclusion: There was no surplus oxygen consumption in post-ischemic hearts when combining ivabradine with dobutamine , Furthermore, addition of ivabradine to dobutamine restored the hemodynamics to pre-ischemic levels by reducing the heart rate and increasing the SV and stroke work while maintaining MAP and CO.
Author Disclosures: J.P. Bakkehaug: None. T. Næsheim: None. E. Engstad: None. A. Kildal: None. T. Myrmel: None. O.J. How: None.
- © 2014 by American Heart Association, Inc.