Inhibition of aldosterone secretion by dopamine, ibopamine, and dihydroergotoxine in patients with congestive heart failure.

There is now evidence for the presence of a dopaminergic inhibitory modulation of aldosterone production that is mediated by D-2 receptors in the adrenal cortex. In this study we evaluated the effects of dopamine and the dopaminergic agonists ibopamine and dihydroergotoxine on aldosterone secretion and plasma renin activity in 13 patients with chronic heart failure. Two groups of patients were noted: one responding to dopaminergic drugs with a decrease in plasma aldosterone and the other without dopamine agonist-related aldosterone suppression. No effect on plasma renin activity was found after each drug administration. A correlation was found between the response to dopamine agonists and basal plasma aldosterone levels. These data are of therapeutic value in showing the detrimental effect of the activation of the renin-angiotensin-aldosterone system occurring in heart failure: a drug reducing this activation appears promising for both its acute and long-term effects.