Clinical experience of therapy with xamoterol in patients with severe systolic and diastolic dysfunction

H. Pouleur, C. Hanet, M. F. Rousseau

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Résumé

Xamoterol ('Corwin', 'Carwin', 'Corwil', 'Xamtol', ICI 118, 587), a partial β-agonist, has beneficial effects in patients with mild to moderate heart failure. In acute haemodynamic studies in more severe heart failure some patients have shown negative inotropic and chronotropic effects, although treatment with a partial agonist should protect the heart against excessive stimulation, while providing a baseline level of sympathetic drive. The study examined the effects of oral xamoterol in patients with moderate to severe heart failure. Ten patients were studied, nine with ischaemic heart disease. All but one were in New York Heart Association (NYHA) functional Class III. Other treatment, including angiotensin converting enzyme (ACE) inhibitors, was continued. The patients underwent a standard bicycle exercise test, and the following day cardiac catheterization was performed to obtain measurements of ventricular size (by cineangiography) and pressures during the cardiac cycle. The patients began treatment with xamoterol 200 mg b.d. in addition to their baseline therapy, and this was continued for an average of 9 weeks, after which the exercise test and the haemodynamic investigations were repeated. At baseline, all patients had a raised left ventricular end-diastolic pressure (LVEDP) and nine had a low election fraction, raised end-systolic and end-diastolic volume indices and reduced left ventricular (+) dP/dt(max) Xamoterol produced a marked reduction in left ventricular filling pressure, a fall in end-systolic volume index and improvements in T1, (+) dP/dt(max) and (dP/dt)/DP40 with no change in mean aortic pressure. Duration of exercise increased in four patients, and did not change in the other four tested. Xamoterol did not affect resting heart rate but reduced the rate on exercise and the degree of ST segment depression. Nine of the ten patients felt better on treatment in terms of fatigue and dyspnoea. In this study, oral xamoterol improved clinical and haemodynamic status in patients with moderately severe heart failure without producing serious side-effect.

langue originaleAnglais
Pages (de - à)33-38
Nombre de pages6
journalEuropean Heart Journal
Volume11
Numéro de publicationSUPPL. A
Etat de la publicationPublié - 1 janv. 1990
Modification externeOui

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