Hemodynamic Effects of Dobutamine in Patients below and over 65 Years, with Left Heart Failure Secondary to an Acute Myocardial Infarction

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Abstract
The cardiac response to sympathomimetic agents has been reported to be reduced in the elderly. The hemodynamic effects of dobutamine was studied in 2 groups of patients with acute myocardial infarction (AMI) and left heart failure: group A included 10 patients aged 65 yr or less and group B 10 others older than 65. After a 1-h infusion the increase in cardiac index was highly significant in both groups (27%, P < 0.001 and 25%, P < 0.001), and the decrease in pulmonary wedge pressure was greater in group A (42%, P < 0.001 and 17%, P < 0.02). The increase in double product was similar in both groups (14% P < 0.001 and 18%, P < 0.005); nevertheless the 4 patients developing angina pectoris during dobutamine infusion were over 65 yr. Dobutamine remains effective in the elderly with AMI and left heart failure but is less well tolerated.

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