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Cardiovascular Club I

11:00 AM

Thursday, February 21, 2013

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EFFECT OF LOW DOSE DOPAMINE INFUSION ON RENAL FUNCTION IN ACUTE DECOMPENSATED HEART FAILURE PATIENTS TREATED WITH INTRAVENOUS FUROSEMIDE

Peters MN1, Alkadri ME2, Katz MJ1, Ventura HO2. 1Tulane University Health Sciences Center, New Orleans, LA and 2Ochsner Medical Center, Jefferson, LA.

Purpose of Study: Worsening renal function (WRF) is common in patients hospitalized with acute decompensated heart failure (ADHF) and is associated with intravenous (IV) furosemide diuresis. Recently it has been shown that addition of low dose dopamine to low-dose furosemide decreased the incidence of WRF while the diuresis remained clinically effective. The effect of dopamine on renal function in patients with ADHF and chronic kidney disease (CKD) is unknown.

Methods Used: Consecutive patients with a history of congestive heart failure, baseline ejection fraction ⩽ 35% and glomerular filtration rate <60 mL min-1 presenting with ADHF were retrospectively assessed. All patients received ≥120mg IV furosemide/24 hours for ≥48 hours. Three cohorts were established based on physician-initiated therapy: (1) low dose dopamine (2-5 μg kg-1 min-1) initiated < 6 hours after presentation (Jan 2010-Jan 2012), (2) low dose dopamine initiated > 24 hours after presentation (Jan 2010- Jan 2012) and (3) no dopamine (Jan 2010-July 2010).

Summary of Results: Patients who received dopamine during hospitalization for ADHF had a significantly decreased incidence of WRF and duration of hospitalization and a non-significant increase in 30 day rehospitalization and 6 month mortality (Table). Timing of dopamine administration did not have a significant effect.

Conclusions: Among patients with CKD admitted for ADHF the addition of low dose dopamine to intravenous furosemide significantly decreased occurrence of WRF and length of hospitalization.

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Table1

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MYOFIBROBLAST SECRETOME AND PATHOLOGIC REMODELING IN HYPERTENSIVE HEART DISEASE

Al Darazi F, Zhao T, Zhao W, Sun Y, Weber KT. University of Tennessee Health Science Center, Memphis, TN.

Purpose of Study: Chronic aldosteronism (inappropriate for dietary Na+) is accompanied …

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