ACUTE EFFECTS OF IBOPAMINE HYDROCHLORIDE ON HEMODYNAMICS, PLASMA-CATECHOLAMINE LEVELS, RENIN-ACTIVITY, ALDOSTERONE, METABOLISM AND BLOOD-GAS IN PATIENTS WITH SEVERE CONGESTIVE-HEART-FAILURE

  • 1 January 1986
    • journal article
    • research article
    • Vol. 36-2  (12) , 1829-1834
Abstract
Acute effects of 200 mg of orally given 4-[2-(methylamino)ethyl]-o-phenylene diisobutyrate hydrochloride (ibopamine hydrochloride) which is a new diisobutyric ester of N-methyldopamine, on hemodynamics and metabolism were evaluated in 11 patients with severe heart failure (New York Heart Association class IV). Significant effects occurred within 30 min and persisted for 6 h after dosing. Peak effects were observed at 2 h. At peak effects, cardiac index increased from 2.53 to 3.07 l/min/m2 (+20%, p < 0.01), stroke volume index from 35 to 41 ml/beat/m2 (+18%, p < 0.05), stroke work index from 35 to 44 g .cntdot. m/beat/m2 (+26%, p < 0.05), urine volume from 50 to 81 ml/h (+61%, p < 0.05), pulmonary capillary wedge pressure decreased from 23 to 18 mmHg (-24%, p < 0.001), mean pulmonary arterial presure from 33 to 27 mmHg (-19%, p < 0.001), right and pressure from 10 to 7 mmHg (-27%, p < 0.001), systemic vascular resistance from 1735 to 1546 dyne .cntdot. s .cntdot. cm-5 (-11%, p < 0.1), pulmonary vascular resistance from 204 to 168 dyne .cntdot. s .cntdot. cm-5 (-25%, p < 0.05), arterio-venous oxygen difference from 6.09 to 5.36 ml/dl (-12%, p < 0.05), norepinephrine from 0.45 to 0.34 ng/ml (-24%, p < 0.1), renin activity 1.80 to 1.26 ng/ml/h (-30%, p < 0.05), respectively, whereas there were no significant changes in blood gases, heart rate, blood pressure, double product, aldosterone, urine Na+,K+ or lactate/pyruvate. Therefore, ibopamine seems to have not only a positive inotropic action but also a potent vasodilating action, leading to both after load and preload reduction, and so to be useful for the treatment of severe heart failure.