Long-term (2 year) beneficial effects of beta-adrenergic blockade with bucindolol in patients with idiopathic dilated cardiomyopathy.

Abstract

Beta-adrenergic blockade represents a promising therapeutic approach to idiopathic dilated cardiomyopathy. Bucindolol, a new beta-blocker, showed favorable effects in a short-term (3 month) trial in idiopathic dilated cardiomyopathy. To assess long-term response, 20 study patients (7 of 9 patients previously assigned to the placebo group and 13 of 14 patients previously assigned to bucindolol therapy) received long-term bucindolol therapy and were followed up for a mean of 23 +/- 4 months (range 17 to 30). The mean patient age was 49 years (range 29 to 66) and the median duration of disease was 11 months (range 1 to 190). Ten patients were in functional class II and 10 were in class III; 15 patients were men. At the end of the common follow-up time, all 20 patients were alive, 17 continued to receive bucindolol (mean dose 176 mg/day, range 25 to 200), and 2 underwent cardiac transplantation. Left ventricular ejection fraction increased from a baseline value of 25 +/- 8% to 35 +/- 13% (n = 19 pairs, p less than 0.001). Functional class improved in 12, was unchanged in 5 and deteriorated in 3 (p = 0.056). Exercise time was maintained (9.4 +/- 3.1 versus 9.1 +/- 3.5 min, n = 19, p = NS), as was maximal oxygen uptake (19.2 +/- 4.9 versus 18.8 +/- 5.7 ml/kg per min, n = 19, p = NS). Thus, long-term bucindolol therapy leads to substantial increases in ejection fraction and to improved functional class while stable exercise performance is maintained.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: J L Anderson, E M Gilbert, J B O'Connell, D Renlund, F Yanowitz, M Murray, M Roskelley, P Mealey, K Volkman, D Deitchman
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) Vol. 17 Issue 6 Pg. 1373-81 (May 1991) ISSN: 0735-1097 [Print] United States
• PMID: 1673132 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenergic beta-Antagonists
• Propanolamines
• bucindolol

Topics

• Adrenergic beta-Antagonists (therapeutic use)
• Adult
• Aged
• Cardiomyopathy, Dilated (drug therapy, physiopathology)
• Exercise Test
• Follow-Up Studies
• Humans
• Middle Aged
• Propanolamines (administration & dosage, therapeutic use)
• Rest
• Stroke Volume (drug effects)
• Time Factors