Pharmacologic Treatment of Congestive Heart Failure

Abstract

regarding pharmacologic treatment of heart failure is interesting for general practitioners in Belgium. However, I was amazed to find the following recommendation in this article: "Fourth, hospitalize the patient and institute intravenous inotropic therapy such as intravenous dobutamine to increase renal blood flow and facilitate diuresis," but no mention for or against oral therapy with ibopamine. Several recent publications have spoken in favor of oral ibopamine use, even during angiotensin-converting enzyme inhibitor treatment.2-4 I wonder whether this may be explained by ibopamine's not being available on the US pharmaceutical market or, on the other hand, because its safety and efficacy have not yet been sufficiently tested and proven. Ibopamine is available in Belgium, England, and the Netherlands. Christian Oosterbosch, MD Les Nouveaux G\l=e'\n\l=e'\ralistes Liege, Belgium 1. Baker DW, Konstam MA, Bottorff M, Pitt B. Management of heart failure, I: pharmacologic treatment. JAMA. 1994;272:1361-1366. 2. Rousseau MF, Konstam MA, Benedict CR, et al. Progression of left ventricular dysfunction secondary to coronary artery disease, sustained neurohormonal activation and effects of ibopamine therapy during long-term therapy with angiotensin\x=req-\ converting enzyme inhibitor. Am J Cardiol. 1994;73:488-493. 3. Buikema H, van Gilst WH, van Velhuisen DJ, et al. Endothelium dependent relaxation in two different models of chronic heart failure and the effects of ibopamine.