Noninvasive assessment of diastolic and systolic properties of ibopamine in patients with congestive heart failure.
The acute effect of a single oral 100 mg dose of ibopamine on systolic and diastolic left ventricular function in nine patients with congestive heart failure was assessed by quantitative M-mode and pulsed Doppler echocardiography. Echocardiography was performed at baseline and 30, 60, and 120 minutes after ingestion of drug. Indices of systolic and diastolic left ventricular function were derived from digitized tracings of the septal and posterior endocardial surfaces and transmitral and aortic valve velocity profiles. Ibopamine significantly improved systolic function as reflected by a decrease in the preejection period to left ventricular ejection time ratio from 0.57 +/- 0.16 at baseline to 0.47 +/- 0.15 (p less than 0.05) 30 minutes after ingestion of drug. The maximum improvements in stroke volume and cardiac output after ibopamine were from 63 +/- 35 to 72 +/- 40 ml (p less than 0.05) and 4.6 +/- 1.7 to 5.4 +/- 2.1 L/min (p = 0.05), respectively. The contribution of atrial systole to total diastolic filling increased from 32 +/- 10% at baseline to 37 +/- 12% (p less than 0.05) after 30 minutes and persisted for at least 120 minutes. The distribution of diastolic filling was significantly altered after ingestion of ibopamine as reflected by a decrease in the ratio of the time-velocity integrals of left ventricular filling during early diastole and atrial systole (Ei/Ai) from 2.44 +/- 1.08 at baseline to 1.98 +/- 0.97 (p less than 0.05) 30 minutes after drug. The decrease in the Ei/Ai persisted for at least 120 minutes. The duration of the effect of ibopamine on diastolic filling persisted longer than its effect on augmenting systolic function. The positive effect of ibopamine on systolic function makes it a promising drug in the treatment of congestive heart failure.
Stoddard
M F
MF
Department of Internal Medicine, St. Louis University School of Medicine, MO.
Chaitman
B R
BR
Byers
S L
SL
Mrosek
D
D
Labovitz
A J
AJ
D000328:Adult; D000368:Aged; D003846:Deoxyepinephrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003971:Diastole / Q000187:drug effects*; D004298:Dopamine / Q000031:analogs & derivatives*; D004452:Echocardiography; D015150:Echocardiography, Doppler; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*; D013599:Systole / Q000187:drug effects*
C023487:ibopamine; D003846:Deoxyepinephrine; D004298:Dopamine