Symptoms, haemodynamics, and exercise capacity during long term treatment of chronic heart failure. Experience with pirbuterol.

Abstract	An open study of long term treatment with an oral beta 2 agonist (pirbuterol 20 mg three times daily) was undertaken in 63 patients with severe chronic heart failure. During three months of treatment 20 (32%) patients died, of whom 16 were taking the drug at the time of death. Mortality was related to initial functional class (New York Heart Association classification: 23% in grade III and 75% in grade IV). Concomitant treatment with digoxin did not affect mortality. The drug was well tolerated by most patients but unwanted side effects necessitated withdrawal of the drug in six (10%). Thirty-five patients were continuing to take the drug after three months, of whom 22 reported symptomatic improvement and only four deterioration. There was a relation between symptomatic improvement and increase in exercise capacity. At initial haemodynamic assessment a single dose of pirbuterol increased the cardiac index by 34% and the stroke index by 21%. Left ventricular filling pressure fell by 23% and systemic vascular resistance by 22%. Haemodynamic reassessment after three months of continuous treatment in 29 patients showed maintained improvement in the group as a whole, although individual variation was considerable. There was no apparent relation between haemodynamic improvement and improvement in exercise duration and symptoms. Severe heart failure has a poor prognosis. Identification of those patients who may derive benefit from treatment with a particular drug is not yet possible.
Authors	J R Dawson, R Canepa-Anson, P Kuan, S R Reuben, P A Poole-Wilson, G C Sutton
Journal	British heart journal (Br Heart J) Vol. 50 Issue 3 Pg. 282-9 (Sep 1983) ISSN: 0007-0769 [Print] England
PMID	6137226 (Publication Type: Journal Article)
Chemical References	Adrenergic beta-Agonists Cardiotonic Agents Ethanolamines pirbuterol
Topics	Adrenergic beta-Agonists (adverse effects, therapeutic use) Adult Aged Cardiotonic Agents (adverse effects, therapeutic use) Ethanolamines (adverse effects, therapeutic use) Female Heart Failure (drug therapy, physiopathology) Hemodynamics (drug effects) Humans Male Middle Aged Physical Exertion Time Factors

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.

Realize the full power of the drug-disease research graph!