Melvyn Rubenfire

Cardiovascular complications of recreational physical activity

In brief To evaluate the incidence of major cardiovascular complications (CVCs) during recreational activity the authors conducted a five-year retrospective survey of fatal and nonfatal CVCs that occurred in community recreation centers during or immediately after exercise. Forty-eight facilities reported 30 nonfatal and 38 fatal CVCs. Although most (57%) occurred during court games and jogging, the data are insufficient to infer any increased relative risk during these activities. There was one nonfatal and one fatal event every 1,124,200 and 887,526 hours of participation, respectively. These data suggest a small acute risk of CVC in the general public during recreational activity.

Dopamine and dobutamine induce hypokalemia in anesthetized dogs

Epinephrine-induced hypokalemia appears to be mediated by beta 2-agonist activation of Na+/K+ ATPase. To determine whether dopamine and dobutamine induce hypokalemia, eight adult mongrel dogs were anesthetized and studied in random crossover fashion. Potassium [K+] was measured with an ion-selective microelectrode, and central hemodynamics were measured continuously. After stabilization, dopamine and dobutamine were infused at doses of 2, 4, 8, and 20 micrograms/kg/min (15-min increments/dose), and 0.9% NaCl was infused at equivalent volumes, with a 1-h washout between treatments. The mean change in [K+] at each infusion rate was compared between treatments among dogs with an adequate hemodynamic response. Among dopamine responders (n = 5), [K+] decreased from 3.74 +/- 0.42 mEq/L at baseline to 3.63 +/- 0.51 at 2 micrograms/kg/min (p less than 0.02) and was not significantly different at higher doses. Among dobutamine responders (n = 7), [K+] decreased from 3.52 +/- 0.74 at baseline to 3.31 +/- 0.87 at 8 micrograms/kg/min (p less than 0.02) and 3.25 +/- 0.86 at 20 micrograms/kg/min (p less than 0.02), and was not significantly different at lower doses. We conclude that dopamine and dobutamine induce significant hypokalemia, consistent with their adrenergic agonist activity, and this may be related to the known arrhythmogenicity of these agents.