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.

Study Design

Study Design:

Patients Screened: 180
Patients Enrolled: 161
NYHA Class: II=(80%), III=(20%)
Mean Follow Up: 6 months
Mean Patient Age: 61
Female: 14
Mean Ejection Fraction: 29%

Patient Populations:

Signs/symptoms of CHF
Ages 18-75
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
Thyroid disease
Hypertrophic cardiomyopathy
Recent myocardial infarction
Exercise limiting angina
COPD limiting exercise capacity

Primary Endpoints:

Exercise capacity

Secondary Endpoints:

Perceived exertion after each exercise stage

Drug/Procedures Used:

Ibopamine 100 mg TID
Furosemide up to 80 mg QD

Concomitant Medications:

Furosemide (100%)
Triampterine (27%)
Antiarrhythmics (11%)
Anticoagulants (41%)
Antiplatelet (39%)

Principal Findings:

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

Clinical Topics: Dyslipidemia, Heart Failure and Cardiomyopathies, Lipid Metabolism, Novel Agents, Statins, Acute Heart Failure

Keywords: Deoxyepinephrine, Renin, Digoxin, Diuretics, Norepinephrine, Furosemide, Vasodilator Agents, Heart Failure, Cardiotonic Agents

< Back to Listings