To evaluate the attenuation of the effectiveness of long-term ibopamine therapy, ibopamine was administered in single doses of 100 and 200 mg to 10 patients with chronic heart disease. The hemodynamic studies using Swan-Ganz catheter and pharmacokinetic studies were carried out. Ibopamine was found to increase cardiac output and stroke index and to decrease systemic vascular resistance in this acute study. Six patients underwent long-term therapy with the drug and were evaluated for the development of tolerance. Three out of 5 patients experienced an improvement in NYHA functional class after 12-23 weeks of treatment. There was no attenuation in the effects of ibopamine on hemodynamics, pharmacokinetic parameters remained almost unchanged, and tolerance was not observed. These results suggest that ibopamine is useful as an orally administered anti-heart failure drug.

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A 72-year-old man underwent sutureless repair of an oozingtype left ventricular free wall rupture. Echocardiography 8 months after sutureless repair revealed a huge left ventricular pseudoaneurysm and severe mitral regurgitation (MR). Therefore, left ventricular reconstruction and restrictive mitral annuloplasty were performed. The patientʼs clinical condition was improved and no residual MR has been detected for 12 months. We conclude that left ventricular reconstruction and restrictive mitral annuloplasty could be useful for left ventricular pseudoaneurysm with MR.