Effect of oral H2-receptor antagonists on left ventricular systolic function and exercise capacity in patients with chronic stable heart failure.
OBJECTIVE
To evaluate the effect of cimetidine, famotidine, ranitidine, and placebo on left ventricular systolic function, aerobic metabolic performance, and exercise capacity in patients with chronic, stable heart failure.


METHODS
Double-blind, randomized, placebo-controlled, four-way crossover study.


METHODS
Outpatient, university-affiliated cardiology clinic.


METHODS
Twelve men with stable New York Heart Association class II or III heart failure secondary to ischemic heart disease or hypertension.


METHODS
Patients received in random sequence cimetidine 400 mg twice/day, famotidine 40 mg/day, ranitidine 150 mg twice/day, and placebo. Each treatment was administered for 7 days, and the periods were separated by a 1-week washout.


RESULTS
Before and after each treatment, patients underwent a bicycle stress echocardiogram with aerobic metabolic assessment. Left ventricular function was evaluated by calculating ejection phase indexes from Doppler echocardiographic measurements. All 12 patients successfully completed the study. No patient reported any adverse effect attributed to study drugs. None of the treatments was associated with significant changes in any measure of left ventricular systolic function, aerobic metabolic performance, or exercise capacity, nor were placebo-subtracted differences for the agents significantly different for any of the three measures.


CONCLUSIONS
The three H2-receptor antagonists administered for 7 days at clinical dosages have no significant effect on left ventricular systolic function, aerobic metabolic performance, or exercise capacity in men with class II or III stable heart failure.
Center for Clinical Sciences Research, Division of Research, Camcare Health Education and Research Institute, Charleston, West Virginia, USA.
B D
BD
Lucas
M A
MA
Williams
S M
SM
Mohiuddin
L J
LJ
LaMadrid
L J
LJ
Schroeder
D E
DE
Hilleman
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D002927:Cimetidine / Q000008:administration & dosage / Q000627:therapeutic use; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004452:Echocardiography / Q000187:drug effects; D004734:Energy Metabolism / Q000187:drug effects; D005080:Exercise Test / Q000187:drug effects; D017079:Exercise Tolerance / Q000187:drug effects*; D015738:Famotidine / Q000008:administration & dosage / Q000627:therapeutic use; D006331:Heart Diseases / Q000188:drug therapy* / Q000503:physiopathology; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011899:Ranitidine / Q000008:administration & dosage / Q000627:therapeutic use; D013599:Systole / Q000187:drug effects / Q000502:physiology; D016277:Ventricular Function, Left / Q000187:drug effects*
D006635:Histamine H2 Antagonists; D015738:Famotidine; D002927:Cimetidine; D011899:Ranitidine