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Changes in cardiac performance and coronary hemodynamics were evaluated during dobutamine infusion in patients with chronic heart failure associated with ischemic heart disease. At the maximal administered dose (10 micrograms/kg per min) cardiac index increased by 54 percent and stroke work index by 65 percent, indicating improved left ventricular function. Coronary sinus flow and myocardial oxygen consumption increased concomitantly, but myocardial lactate production occurred in only one of eight patients. These findings suggest that improved left ventricular function with dobutamine is associated with increased myocardial oxygen consumption; however, overt myocardial ischemia occurs infrequently.
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