Haemodynamic Effects of Dobutamine and Nitrite in LV Dysfunction
Status:
Unknown status
Trial end date:
2018-06-01
Target enrollment:
Participant gender:
Summary
Patients with poor heart function can, in certain situations, have a further weakening of the
heart muscle such that it becomes difficult to provide enough blood to the brain and other
organs. In these cases, heart function can be supported by the use of medicines or heart
pumps. One of the most widely used medicines is Dobutamine, given as an infusion (a drip).
Although Dobutamine has been in use for decades and does improve blood flow to the organs,
previous studies have not shown any impact on recovery of heart muscle function and survival.
Key to unravelling this discrepancy is to understand the precise effects of Dobutamine on the
oxygen supply to, and oxygen usage by, the heart muscle. We also aim to find out whether
simultaneous infusion of another drug called Nitrite (naturally occurring substance that is
found in beetroot for example, much like GTN) can enhance the beneficial effects of
Dobutamine on the oxygen supply-demand balance of the heart. In recent years, major advances
in technology mean that it is now possible to obtain this information in patients undergoing
coronary angiography procedures by making detailed measurements of heart muscle function and
blood flow in the heart arteries using a conductance catheter (measures volume and pressure
within the main pumping chamber of the heart) and the Combowire (dual pressure and flow
sensor tip angioplasty guidewire). The aim of this study is to understand the effect of a
brief infusion of Dobutamine and nitrite on heart muscle function, oxygen supply and oxygen
usage through this use of this technology, directly following the patients routine coronary
angiogram. Patients will have these measurements taken using the technology described above
during the infusion of both dobutamine and nitrite, inserted through blood vessels that reach
the heart.