Cavalli A, Riva E, Schleman M, Abbondati G, Fuccella L M
Department of Cardiology, Ospedale Generale G., Milan, Italy.
Int J Cardiol. 1989 Mar;22(3):381-7. doi: 10.1016/0167-5273(89)90280-5.
The substitution of digoxin with ibopamine, a new inotropic and vasodilating agent, was evaluated in a multicenter study in 58 patients with mild-to-moderate congestive heart failure, stabilized on diuretics, and digoxin therapy. The study was a parallel, double-blind, randomized trial of four weeks duration in which half of the group continued the pre-study medication (diuretics and digoxin) and half of the group was treated with diuretics and ibopamine (100 mg, three times a day). At baseline evaluation, the two groups were similar for age, sex, underlying cardiac disease, duration of congestive heart failure, symptom score, cardiothoracic ratio, echocardiographic parameters of left ventricular function and exercise tolerance as measured by bicycle ergometry. After four weeks, no clinical deterioration was found in the patients treated with ibopamine in any measured parameter. There were two deaths during the study: a sudden death and one following an acute myocardial infarction. Both patients were on digoxin. This study suggests that in patients with mild-to-moderate congestive heart failure, ibopamine therapy may effectively and safely substitute digoxin therapy for up to four weeks, representing an option for patients requiring inotropic support but are at risk for potential digoxin toxicity.
在一项多中心研究中，对58例轻至中度充血性心力衰竭患者进行了评估，这些患者在使用利尿剂和地高辛治疗后病情稳定，现用新型强心和血管舒张剂异波帕胺替代地高辛。该研究为一项为期四周的平行、双盲、随机试验，其中一半患者继续使用研究前的药物治疗（利尿剂和地高辛），另一半患者接受利尿剂和异波帕胺治疗（100毫克，每日三次）。在基线评估时，两组患者在年龄、性别、基础心脏病、充血性心力衰竭持续时间、症状评分、心胸比率、左心室功能的超声心动图参数以及通过自行车测力计测量的运动耐量等方面相似。四周后，接受异波帕胺治疗的患者在任何测量参数中均未发现临床恶化。研究期间有两例死亡：一例猝死，一例急性心肌梗死后死亡。两名患者均在使用地高辛。这项研究表明，对于轻至中度充血性心力衰竭患者，异波帕胺治疗在长达四周的时间内可有效且安全地替代地高辛治疗，这为需要强心支持但有潜在地高辛毒性风险的患者提供了一种选择。
