Impact of blockade of histamine H2 receptors on chronic heart failure revealed by retrospective and prospective randomized studies.

Abstract

OBJECTIVES:

The goal of this work was to determine whether the blockade of histamine H2 receptors is beneficial for the pathophysiology of chronic heart failure (CHF).

BACKGROUND:

Because CHF is one of the major life-threatening diseases, we need to find a novel effective therapy. Intriguingly, our previous study, which predicts the involvement of histamine in CHF, suggests that we should test this hypothesis in patients with CHF.

METHODS:

We selected 159 patients who received famotidine among symptomatic CHF patients for the retrospective study. We blindly selected age- and gender-matched CHF patients receiving drugs for gastritis other than histamine H2 receptor blockers as a control group. For the prospective study, 50 symptomatic CHF patients were randomly divided into 2 groups. One group received famotidine of 30 mg/day for 6 months, and the other group received teprenone.

RESULTS:

In the retrospective study, famotidine of 20 to 40 mg decreased both left ventricular end-diastolic and end-systolic lengths (LVDd and LVDs, respectively) and the plasma B-type natriuretic peptide (BNP) levels (182 +/- 21 vs. 259 +/- 25 pg/ml, p < 0.05) with unaltered fractional shortening (FS). In a randomized, open-label study, compared with teprenone, famotidine of 30 mg prospectively decreased both New York Heart Association functional class (p < 0.05) and plasma BNP levels (183 +/- 26 pg/ml vs. 285 +/- 41 pg/ml, p < 0.05); this corresponded to decreasing both LVDd (57 +/- 2 mm vs. 64 +/- 2 mm, p < 0.05) and LVDs (47 +/- 2 mm vs. 55 +/- 2 mm, p < 0.05) with unaltered FS (15 +/- 1% vs. 17 +/- 1%). The frequency of readmission because of worsening of CHF was lower in the famotidine group (4% and 24%, p < 0.05). On the other hand, teprenone had no effects on CHF.

CONCLUSIONS:

Famotidine improved both cardiac symptoms and ventricular remodeling associated with CHF. Histamine H2 receptor blockers may have therapeutic benefits for CHF.

• Authors: Jiyoong Kim, Akiko Ogai, Satoshi Nakatani, Kazuhiko Hashimura, Hideaki Kanzaki, Kazuo Komamura, Masanori Asakura, Hiroshi Asanuma, Soichiro Kitamura, Hitonobu Tomoike, Masafumi Kitakaze
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) Vol. 48 Issue 7 Pg. 1378-84 (Oct 03 2006) ISSN: 1558-3597 [Electronic] United States
• PMID: 17010798 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Histamine H2 Antagonists
• Receptors, Histamine H2
• Famotidine

Topics

• Aged
• Cardiac Output, Low (drug therapy, physiopathology)
• Chronic Disease
• Famotidine (therapeutic use)
• Female
• Gastroesophageal Reflux (drug therapy)
• Histamine H2 Antagonists (therapeutic use)
• Humans
• Male
• Prospective Studies
• Receptors, Histamine H2 (physiology)
• Retrospective Studies
• Ventricular Dysfunction, Left (drug therapy)