selective β1 agonist that has been most widely used in patients with heart
failure is dobutamine. This
parenteral drug produces an increase in cardiac output together with a decrease
in ventricu-lar filling pressure. Some tachycardia and an increase in
myocar-dial oxygen consumption have been reported. Therefore, the potential for
producing angina or arrhythmias in patients with coronary artery disease is
significant, as is the tachyphylaxis that accompanies the use of any β stimulant.
Intermittent dobutamine infusion may benefit some patients with chronic heart
has also been used in acute heart failure and may be particularly helpful if
there is a need to raise blood pressure.