Acute and long-term hemodynamic effects of oral pirbuterol in patients with chronic severe congestive heart failure: randomized double-blind trial.

Abstract

In 20 patients with severe congestive heart failure (CHF), we studied the effects of the beta-adrenergic agonist pirbuterol compared to placebo in both an acute double-blind randomized trial and after long-term treatment. Acutely, pirbuterol patients (n = 10) demonstrated a significant rise in cardiac index (2.2 +/- 0.14 to 3.2 +/- 0.32 L/min/m2), stroke index (26 +/- 2.6 to 35 +/- 2.9 ml/beat/m2), stroke work index (22 +/- 2.4 to 30 +/- 2.7 gm X m/m2), and ejection fraction (22 +/- 4 to 30 +/- 5%). These hemodynamic variables did not significantly change in placebo patients (n = 10). After 3 weeks of pirbuterol therapy, 14 patients (70%) were symptomatically improved and were continued on the drug for another 3 weeks; 13 of 14 patients who were symptomatically improved underwent restudy. Compared to pretreatment baseline, there was continued improvement in cardiac index (2.5 +/- 0.16 to 3.2 +/- 0.24 L/min/m2), stroke index (30 +/- 2.5 to 38 +/- 2.9 ml/beat/m2), stroke work index (26 +/- 2.3 to 35 +/- 3.1 gm X m/m2), and ejection fraction (24 +/- 1 to 28 +/- 4%). Patients more frequently improved were those with nonischemic cardiomyopathy and those with higher initial ejection fractions. These results demonstrate the acute beneficial effects of oral pirbuterol versus placebo in a double-blind randomized trial. Improvement was maintained during long-term therapy in the majority of CHF patients.

• Authors: F X Pamelia, M Gheorghiade, G A Beller, H L Bishop, A Y Olukotun, C R Taylor, D D Watson, A M Grunwald, J Sirowatka, B A Carabello
• Journal: American heart journal (Am Heart J) Vol. 106 Issue 6 Pg. 1369-76 (Dec 1983) ISSN: 0002-8703 [Print] United States
• PMID: 6359846 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Bronchodilator Agents
• Ethanolamines
• Placebos
• pirbuterol

Topics

• Administration, Oral
• Adult
• Aged
• Bronchodilator Agents (administration & dosage)
• Chronic Disease
• Clinical Trials as Topic
• Double-Blind Method
• Drug Evaluation
• Ethanolamines (administration & dosage)
• Heart Failure (drug therapy)
• Humans
• Middle Aged
• Placebos
• Random Allocation
• Stroke Volume