Comparative Effects of Ibopamine and Captopril in Mild Congestive Heart Failure

Abstract

Twenty-three patients with mild heart failure (I-II NYHA classes) on digitalis and diuretics were assigned to the following treatment in a random and double-blind fashion: ibopamine-captopril, ibopamine-placebo, captopril-placebo, and placebo-placebo. The doses of captopril and ibopamine were respectively 25 mg t.i.d. and 100 mg t.i.d. The incremental exercise time (until exhaustion) and the peak VO₂ (oxygen consumption) the indexes of left ventricular function (by echo and nuclear stethoscope) and ventricular arrhythmias (evaluated by prolonged Holier monitoring) were assessed before randomization, at 45 days and at 3 months. Ejection fraction, exercise time, peak VO₂, ventricular arrhythmias and heart rate (at rest and during exercise) appeared to be equally unaffected by each treatment. Our results show that ibopamine exerts no significant effects on either heart rate or ventricular arrhythmias and that indexes of left ventricular function are not modified by any treatment in mild congestive heart failure.

A meta‐analysis of the effect of angiotensin‐converting enzyme inhibitors on functional capacity in patients with symptomatic left ventricular systolic dysfunction

“…Thus, out of the 49 published studies only 29 studies were retained. Further 11 studies evaluating the effect of ACE inhibitor vs. placebo [11,17–27], three studies evaluating 1‐year treatment [9,28,30], and two studies evaluating low vs. high dose without placebo arm [36,37] were also excluded. These 16 studies were characterised by small populations (<50 patient, the vast majority included 10–30 patients) and had a wide range of confidence interval for effect size inducing significant heterogeneity ( P =0.0009) together with the large multi‐centre studies and possible publication bias (fig.…”

Hemodynamic Effects and Pharmacokinetics of Long-Term Therapy with Ibopamine in Patients with Chronic Heart Failure

“…The hemodynamic effects of such high ibopamine doses have been analyzed [ 12], Some recent studies [ 12,22,23,33,36,[39][40][41] suggest that 100 mg t.i.d. constitutes the optimal ibopamine dose in terms of clinical efficacy and safety in the long-term treatment of ibopaminc.…”