Double-Blind Placebo-Controlled Study of Ibopamine and Diagoxin in Patients With Mild to Moderate Heart Failure: Results of the Dutch of the Ibopamine Multicenter Trial (DIMT)
| Autor: | Kong I. Lie, A.J. Withagen, J.Cees Poortermans, W.Hans Pasteuning, Henk J.M. Dohmen, Arie J. Man in't Veld, Dirk J. Lok, Jan Brouwer, Peter H. J. M. Dunselman, Dirk J. van Veldhuisen |
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| Jazyk: | angličtina |
| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Digoxin Cardiotonic Agents Adolescent Dopamine Agents Placebo-controlled study EPININE Placebo Severity of Illness Index LONG-TERM THERAPY Double-Blind Method Internal medicine Ibopamine Renin medicine Humans Prospective Studies Aldosterone Aged Netherlands Heart Failure Ejection fraction PLASMA business.industry Furosemide Captopril Middle Aged PERFORMANCE medicine.disease Surgery CATECHOLAMINES Deoxyepinephrine HEMODYNAMICS NOREPINEPHRINE Heart failure Cardiology Electrocardiography Ambulatory Exercise Test DIGITALIS CAPTOPRIL Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of the American College of Cardiology, 22(6), 1564-1573. ELSEVIER SCIENCE INC |
| ISSN: | 0735-1097 |
| Popis: | Objectives. This study was conducted to determine the efficacy and safety of long-term treatment with the orally active dopamine agonist ibopamine in patients with mild to moderate chronic congestive heart failure and to compare the results with those of treatment with digoxin and placebo.Background. Ibopamine and digoxin are drugs that exert hemodynamic and neurohumoral effects. Because there is accumulating evidence that progression of disease in chronic heart failure is related not only to hemodynamic but also to neurohumoral factors, both drugs might be expected to have a favorable long-term effect.Methods. We studied 161 patients with mild to moderate chronic heart failure (80% in New York Heart Association functional class II and 20% in class In), who were treated with ibopamine (n = 53), digoxin (n = 55) or placebo (n = 53) for 6 months. Background therapy consisted of furosemide (0 to 80 mg); all other drugs for heart failure were excluded. Clinical assessments were made at baseline and after 1, 3 and 6 months.Results. Of the 161 patients, 128 (80%) completed the study. Compared with placebo, digoxin but not ibopamine significantly increased exercise time after 6 months (p = 0.008 by intention to treat analysis). Ibopamine was only effective in patients with relatively preserved left ventricular function, as it significantly increased exercise time in this subgroup (for patients with a left ventricular ejection fraction > 0.30; p = 0.018 vs, placebo). No patient receiving digoxin withdrew from the study because of progression of heart failure, compared with six patients receiving ibopamine and two receiving placebo. At 6 months, plasma norepinephrine was decreased with digoxin and ibopamine therapy (-106 and -13 pg/ml, respectively) but increased with placebo administration (+62 pg/ml) (both p Conclusions. Ibopamine and digoxin both inhibit neurohumoral activation in patients with mild to moderate chronic heart failure. However, the clinical effects of these drugs are different and appear to be related to the degree of left ventricular dysfunction. |
| Databáze: | OpenAIRE |
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