Download The effects of dobutamine-ivabradine combination and omecamtiv

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The effects of dobutamine-ivabradine combination
and omecamtiv treatment on the diastolic
in a porcine model of acute ischemic heart failure
Leif Rønning DVM, Jens Petter Bakkehaug MD, Lars Rødland Stud.med.,
Anders Benjamin Kildal MD PhD, Truls Myrmel MD PhD, Ole-Jakob How PhD
Cardiovascular Research Group, Department of Medical Biology
Faculty of Health Sciences, UiT The Arctic University of Norway
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Background and hypothesis
Acute diastolic failure in ischemic cardiogenic shock is associated
with a grave prognosis.
Improving SV is beneficial to these patients, but they already have a elevated heart rates.
There is a rationale for finding an inotropic treatment without further elevating the heart
rate.
Hypothesis: The combined treatment with the catecholamine
Dobutamine and the sinus node If-channel inhibitor Ivabradine exerts
different lusitropic effects on early diastole in acute heart failure than
the treatment with the myosin activator omecamtiv.
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Methods
Anesthetized pigs were subjected to left ventricular ischemia by injection of polystyrene
microspheres into the coronary main stem (n=12).
The animals were then randomized to receive omecamtiv (OM) (bolus 0.75 mg/kg plus 0.5
mg/kg/h) (n=6) or a combination of dobutamine (infusion 5 µg/kg/min) and ivabradine
(bolus 0.29 ±0.16 mg/kg) (D+I) (n=6).
Assessments were done at intrinsic HR, and pacing at 120 and 160 BPM
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Results
No significant change in HR in
any of the treatment groups
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Results
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Conclusion
The partially restored diastolic suction and lusitropic effect of combined
dobutamine-ivabradine treatment is important to restore cardiac output and
stroke volume in acute ischemic heart failure.
This effect was not observed in the omecamtiv-treated animals.