Comparison of acute haemodynamic effects of dopexamine hydrochloride, dobutamine and sodium nitroprusside in chronic heart failure

Dopexamine hydrochloride (Dopacard®) is a new syntheticcatecholamine compound, which possesses potent ß2-adrenergicand D A 1-dopaminergic agonistic properties. It is free of a-adrenergicactivity, has no ß1-adrenergic activity and is lesspotent at D A2-dopaminergic receptors than dopamine. In thepresent study the acute haemodynamic effects of dopexamine hydrochloridewere compared to those of dobutamine and nitroprusside in 12patients with idiopathic congestive cardiomyopathy in an opencrossover study. With dopexamine hydrochloride, there were dose-dependentincreases from control in cardiac output and stroke volume,decreases in blood pressure, right and left atrial pressure,systemic vascular resistance and pulmonary vascular resistanceand little change in heart rate. Similar effects were seen withnitroprusside, apart from a marked increase in heart rate, andwith dobutamine, except that systolic aortic blood pressureincreased and there was no change in diastolic or mean pressureor pulmonary artery systolic pressure. In general, dopexamine hydrochloride produced effects betweenthose produced by the other two treatments. This suggests thatdopexamine with its combined vasodilator and inotropic actionhas a desirable cardiovascular profile with advantages overthe ß1-receptor aganist dobutamine and the pure vasodilatorsodium nitroprusside.