Peripheral hemodynamic effects of ibopamine in patients with congestive heart failure. A placebo-controlled, double-blind study

Longhini, C; Ansani, L; Musacci, G. F.; Aggio, Silvio; Baracca, Enrico; Toselli, Tiziano; Ghirardi, P

doi:10.1007/bf01883865

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…At an unchanged heart rate and mean arterial blood pressure, in accordance with the literature [4][5][6][7][8][9][10][11][12][13][14][15][16], the transient rise in arterial pulse pressure after IBO is probably caused by a rise in stroke volume and cardiac output rather than a fall in arterial compliance. Indeed, cardiac output may rise already = 0.5 h after a single oral dose of = 200 mg IBO, and this increase may be maintained for ~ 4 h, while, in some studies, systemic vascular resistance fell only -~ 1-2 h after administration following a transient rise in arterial pressure [4][5][6][7][8][9][10][11][12][13][14][15][16]. Hence, the early and transient rise in thoracic blood volume may have been caused by cardiac enlargement in response to a temporary increase in systolic blood pressure and, thus, left ventricular afterload in the absence of an effect on peripheral veins and in spite of the positive inotropic effect of the dose (200 mg) of IBO used [4][5][6][7][8][9][10][11][12][13][14].…”

Section: Discussionsupporting

confidence: 75%

“…This finding contrasts with studies in healthy volunteers and patients with CHF, as measured by strain-gauge plethysmography, the drug increased blood flow and dilated veins in the forearm, starting = 1.5 h after a single 150-rag dose; this could be prevented by prior blockade of dopamine receptors [15,16]. The discrepancy may relate to differences in methods, doses or both.…”

Section: Discussioncontrasting

confidence: 54%

“…However, the effect on cardiac preload is less clear [4][5][6][7][8][9][10][11][12][13][14]. As measured by plethysmography, IBO may increase forearm blood volume in healthy volunteers and patients with CHF [15,16]. This may contradict volumetric studies in animals and man showing that dopamine tends to constrict peripheral veins [17,18]:…”

contrasting

confidence: 39%

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Acute effect of ibopamine and isosorbide mononitrate on blood volume distribution in congestive heart failure

Holman

Groeneveld

Schneider

et al. 1994

Eur J Clin Pharmacol

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In order to compare ibopamine (IBO), a dopamine congener, with isosorbide mononitrate (ISMN) and to study their interaction in effects on the capacitance vasculature in congestive heart failure (CHF), a prospective, randomized, placebo-controlled, double-blind clinical trial was performed in 32 patients with New York Heart Association class II-IV CHF, randomly assigned to receive single oral doses of placebo, 200 mg IBO, 20 mg ISMN, or both IBO and ISMN. After labelling of red cells with 99mTc, changes in regional radioactivity, indicative of changes in blood volume, were recorded using a gamma-camera before and at 30, 60 and 120 min after drug administration. At 30 and 60 min, arterial systolic and pulse pressures were higher with IBO than with ISMN and placebo (for pulse pressure by mean 13.7 mmHg, 95% confidence interval 4.5-23.0 mmHg, at 30 min), probably reflecting an IBO-induced rise in stroke volume at unchanged heart rate and mean arterial pressure. IBO did not change regional radioactivity except for a transient increase of 4.4% (0.5-7.6%) in the thorax at 30 min. This was attenuated by concomitant ISMN treatment since, starting at 30 min, the drug increased radioactivity in the legs, compared with patients not receiving the drug, by 8.0% (95% confidence interval 0.2-15.8%), leading to a fall in thoracic and left ventricular radioactivity at 30 min of 3.4% (0.3-7.0%) and 6.4% (0.8-11.9%), respectively, and a fall of 5.5% (0.5-10.5%) in hepatic radioactivity at 60 min.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 75%

Section: Discussioncontrasting

confidence: 54%

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Acute effect of ibopamine and isosorbide mononitrate on blood volume distribution in congestive heart failure

Holman

Groeneveld

Schneider

et al. 1994

Eur J Clin Pharmacol

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“…In patients with congestive heart failure, forearm arterial blood flow and venous capacity increased by 25 to 45% and 18%, respectively, and peripheral arterial resistance decreased by 35%, as assessed by strain-gauge plethysmography, in response to a single oral dose of ibopamine 150mg (Longhini et al 1989;Musacci et al 1986). These effects were significantly suppressed by sulpiride, a specific dopaminergic antagonist.…”

Section: Peripheral Haemodynamic Effectsmentioning

confidence: 99%

Ibopamine

Spencer¹,

Faulds²,

Fitton³

1993

Drugs & Aging

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Ibopamine is an orally administered dopamine agonist which is rapidly converted to its active metabolite epinine by esterase hydrolysis. Ibopamine acts predominantly as a vasodilator and inhibitor of neuroendocrine activation in congestive heart failure, but also has mild positive inotropic effects at higher doses. The beneficial effects on cardiac and systemic haemodynamic parameters seen in short term studies have been maintained in predominantly noncomparative trials for up to 1 year, and improvements in New York Heart Association (NYHA) functional class and clinical symptoms have been observed in patients with congestive heart failure of varying severity. In double-blind studies conducted in small numbers of patients, the efficacy of ibopamine was comparable to that of digoxin, captopril, enalapril and hydrochlorothiazide. Ibopamine can successfully replace treatment with intravenous dopamine in patients with severe heart failure, and is effective and well tolerated when administered in combination with digoxin, diuretics and/or angiotensin converting enzyme (ACE) inhibitors. Ibopamine has shown no detrimental effects on renal function, few adverse effects on neurohormonal parameters and has demonstrated no significant proarrhythmic properties at therapeutic doses in patients with congestive heart failure. No adverse metabolic effects were observed during ibopamine therapy in patients with diabetes mellitus, nor did ibopamine have detrimental effects in patients with chronic obstructive pulmonary disease. While reliable evidence is required concerning effects on mortality before the role of ibopamine can be clearly defined, the drug appears to be a useful agent for combination with conventional therapies in treating patients with mild to severe congestive heart failure.

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Clinical efficacy of ibopamine in patients with chronic heart failure

Metra

Del

1995

Clin Cardiol

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Summary: Ibopamine, the most widely studied dopaminergic drug for the treatment of chronic heart failure, appears to have beneficial hemodynamic, renal, and neurohormonal effects in this setting. Angiotension-converting enzyme (ACE) inhibitors have become the recommended standard treatment for chronic heart failure; however, some patients may benefit from additional drugs to improve their symptoms and functional capacity. Ihopamine may be effective as an additive drug for patients with chronic heart failure. It is also possible that ibopamine will improve survival in these patients. Large-scale trials are needed to assess the effects on morbidity and mortality when ibopamine is added to ACE inhibitors, diuretics, and possibly digitalis.

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Peripheral hemodynamic effects of ibopamine in patients with congestive heart failure. A placebo-controlled, double-blind study

Cited by 3 publications

References 9 publications

Acute effect of ibopamine and isosorbide mononitrate on blood volume distribution in congestive heart failure

Acute effect of ibopamine and isosorbide mononitrate on blood volume distribution in congestive heart failure

Ibopamine

Clinical efficacy of ibopamine in patients with chronic heart failure

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