Double-Blind Placebo-Controlled Study of Ibopamine and Digoxin in Patients with Mild to Moderate Heart failure: Results of the Dutch Ibopamine Multic - DIMT
Ibopamine for exercise capacity in stable heart failure.
Ibopamine is clinically effective in patients with stable heart failure.
Patients Screened: 180
Patients Enrolled: 161
NYHA Class: II=(80%), III=(20%)
Mean Follow Up: 6 months
Mean Patient Age: 61
Mean Ejection Fraction: 29%
Signs/symptoms of CHF
Stable on oral meds for > 2 weeks (maximum of furosemide 80mg QD allowed)
MUGA ejection fraction < 45% (within prior 2 months)
Ability to exercise (bicycle) < 4 minutes
Valvular or congenital heart disease
Recent myocardial infarction
Exercise limiting angina
COPD limiting exercise capacity
Perceived exertion after each exercise stage
Ibopamine 100 mg TID
Furosemide up to 80 mg QD
Six of 53 patients taking ibopamine dropped out due to increased congestive heart failure; 0/55 on digoxin.
Exercise time decreased in patients treated with placebo after 6 months (median -62 seconds; p less than 0.05 vs baseline), but it increased with ibopamine (+48 seconds), and digoxin (+17 seconds; both p less than 0.05 vs placebo).
Plasma norepinephrine and renin were significantly decreased by digoxin and ibopamine.
Functional class, ambulatory arrhythmias, and mortality were not significantly affected by either drug.
"Even in stable, untreated heart failure, a small but significant progression of disease occurs during 6 months, as reflected by both clinical and neurohumoral changes. Both ibopamine and digoxin monotherapy may favorably affect these changes, and may thus be of value in this patient group."
1. J Am Coll Cardiol 1993;22:1564-73. Final results
2. Am J Cardiol 1995;75:796-800. 6-month neurohormonal effects
3. J Am Coll Cardiol 1995;26:983-90. Heart rate variability
Keywords: Deoxyepinephrine, Renin, Digoxin, Diuretics, Norepinephrine, Furosemide, Vasodilator Agents, Heart Failure, Cardiotonic Agents
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