Clinical efficacy of pimobendan (UD-CG 115 BS) in patients with chronic congestive heart failure.
The pyridazoline derivative UD-CG 115 BS (pimobendan) is a noncatecholamine, nonglycoside new inotropic compound with potent vasodilator properties that exerts stimulatory myocardial effects by increasing the Ca2+ affinity of cardiac contractile proteins, thus improving Ca2+ utilization. The aim of the present study was to characterize and quantify the hemodynamic effects of oral UD-CG 115 BS in 25 patients with idiopathic congestive cardiomyopathy (NYHA stage III) and compare these to the action of the beta 1-receptor agonist dobutamine. UD-CG 115 BS 5 mg p.o. increased cardiac output, cardiac index, and stroke volume index by approximately 60%. With only minor changes in heart rate, ventricular filling pressures decreased (-40%) and there was a decline in pulmonary and systemic vascular resistance (-50%), as well as in systolic, diastolic, and mean pulmonary artery pressure (-35%). The effects of 5 mg UD-CG 115 BS were comparable to the optimal dose of dobutamine, while 10 mg induced significantly more pronounced hemodynamic changes. The effects of UD-CG 115 BS lasted for at least 12 h. No major side effects were observed. A continuous treatment with 10 mg of UD-CG 115 BS/day over a period of 5 days resulted in a significantly improved response to beta-adrenoceptor stimulation while endogenous plasma catecholamines fell down to nearly normal values. It is concluded that UD-CG 115 BS, with its unique receptor independent mechanism of action, may represent a new therapeutic approach for management of congestive heart failure patients.
Baumann
G
G
First Department of Medicine, Technical University of Munich, F.R.G.
Ningel
K
K
Permanetter
B
B
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy*; D002316:Cardiotonic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002908:Chronic Disease; D004280:Dobutamine / Q000494:pharmacology; D006333:Heart Failure / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D009599:Nitroprusside / Q000494:pharmacology / Q000627:therapeutic use; D011651:Pulmonary Artery / Q000502:physiology; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D011724:Pyridazines / Q000494:pharmacology / Q000627:therapeutic use*; D011943:Receptors, Adrenergic, beta / Q000502:physiology; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D014655:Vascular Resistance
D002316:Cardiotonic Agents; D011724:Pyridazines; D011943:Receptors, Adrenergic, beta; D009599:Nitroprusside; C041648:pimobendan; D004280:Dobutamine