Circulation, Vol 84, 2426-2441, Copyright © 1991 by American Heart Association
SL Woodley, EM Gilbert, JL Anderson, JB O'Connell, D Deitchman, FG Yanowitz, PC Mealey, K Volkman, DG Renlund and R Menlove
BACKGROUND. We investigated the effects of bucindolol, a nonselective,
non-ISA beta-blocker with mild-vasodilatory properties, in patients with
congestive heart failure from ischemic dilated cardiomyopathy (ISCDC, n =
27) and compared the results with those in subjects with heart failure from
idiopathic dilated cardiomyopathy (IDC, n = 22). METHODS AND RESULTS.
Patients were randomized in a double-blind fashion to receive 12 weeks'
treatment with either bucindolol or placebo, with randomization stratified
for IDC or ISCDC. Invasive (right heart catheterization) and noninvasive
(echo, MUGA, central venous norepinephrine, exercise treadmill studies, and
symptom scores) tests of heart failure severity were determined at baseline
and end of the study. For all subjects (ISCDC plus IDC), relative to
placebo treatment, bucindolol-treated patients had significant improvement
in ejection fraction, left ventricular size and filling pressure, stroke
work index, symptom score, and central venous norepinephrine. However, most
of these differences could be attributed to improvement in the IDC
subgroup, as the only parameter with a statistically significant degree of
improvement in the bucindolol-treated ISCDC subgroup was left ventricular
size. CONCLUSIONS. We conclude that beta-blockade may produce
quantitatively different degrees of response in different kinds of heart
muscle disease.
ARTICLES
Beta-blockade with bucindolol in heart failure caused by ischemic versus idiopathic dilated cardiomyopathy
Heart Failure Treatment Program, University of Utah School of Medicine, Salt Lake City.
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