[Acute and chronic effects of UDCG 115 BS (pimobendan) in patients with advanced myocardial failure].
In a double-blind, placebo-controlled cross-over study acute hemodynamic effects of oral UDCG 115 BS (5 and 10 mg) were investigated in myocardial heart failure before (n = 16) and after (n = 13) chronic treatment (4 weeks). Before chronic treatment, UDCG 115 BS induced a similar increase in cardiac index with both doses (5 mg: from 2.4 +/- 0.7 to 3.5 +/- 0.7 l/min/m2, p less than 0.001; 10 mg: from 2.5 +/- 0.6 to 3.6 +/- 0.9 l/min/m2, p less than 0.001). Both right atrial pressure and pulmonary capillary wedge pressure were clearly reduced (p less than 0.001). Heart rate increased slightly only after 5 mg (p less than 0.05). Systemic vascular resistance was reduced (p less than 0.001), whereas mean blood pressure did not change. After chronic treatment (2 x 5 or 2 x 10 mg/d) and cessation of medication for 24 h there was no difference for control hemodynamic values as compared to placebo. Acute hemodynamic effects were considerably attenuated in comparison with the results obtained before chronic treatment. NYHA-classification, however, clearly (p less than 0.05) improved during administration of UDCG 115 BS as compared to placebo. Two patients died on placebo, whereas no patient expired on verum. This might indicate a therapeutic longterm effect of UDCG 115 BS, despite the observed development of partial tolerance.
Permanetter
B
B
Technische Universität München, I. Medizinische Klinik.
Baumann
G
G
Wirtzfeld
A
A
Günes
S
S
Stinshoff
M
M
Klein
G
G
D000328:Adult; D000368:Aged; D002302:Cardiac Output / Q000187:drug effects; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006333:Heart Failure / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011724:Pyridazines / Q000008:administration & dosage*
D002316:Cardiotonic Agents; D011724:Pyridazines; C041648:pimobendan
Akute und chronische Wirkungen von UDCG 115 BS (Pimobendan) bei Patienten mit fortgeschrittener myokardialer Insuffizienz.