Document Detail

Comparison of hormonal and haemodynamic changes after long-term oral therapy with pimobendan or enalapril--a double-blind randomized study.
MedLine Citation:
PMID:  1915427     Owner:  NLM     Status:  MEDLINE    
Twenty-four patients (one female, 23 male) with mild to moderate heart failure were randomly and double-blindly assigned to an oral treatment with 5 mg enalapril twice daily or 5 mg pimobendan (UDCG 115) twice daily. After the first tablet intake, blood pressure and heart rate were measured for 6 h. Therapy continued over 6 months. Systolic arterial blood pressure dropped from 126 +/- 20 mmHg to 111 +/- 14 mmHg (P less than 0.05) after the first enalapril tablet and from 123 +/- 16 mmHg to 112 +/- 13 mmHg (P less than 0.05) after the first pimobendan tablet. After 6 months, no important changes in blood pressure were observed in the pimobendan group and only a minor decrease in the enalapril group. There was no significant change in heart rate either after the first dose or after long-term therapy with either medication. After 6 months, cardiac index increased from 2.73 +/- 0.75 l.min-1.m-2 to 3.38 +/- 0.69 l.min-1.m-2 (P less than 0.01) after pimobendam, but did not change after enalapril (2.95 +/- 0.75 l.min-1.m-2 to 2.96 +/- 0.89 l.min-1.m-2, NS). Pulmonary capillary wedge pressure decreased during pimobendan long-term therapy from 16 +/- 8 mmHg to 14 +/- 8 mmHg (NS) and during enalapril from 21 +/- 7 to 14 +/- 7 mmHg (P less than 0.01). Exercise capacity increased in the pimobendan group from 17.2 +/- 5.4 kJ to 23.0 +/- 9.6 kJ (P less than 0.05), and in the enalapril group from 20.4 +/- 11.9 kJ to 24.8 +/- 18.5 kJ (NS) during long-term therapy over 6 months. Plasma renin activity increased from 0.96 to 3.6 (P less than 0.05) during enalapril long-term therapy, but remained unchanged (1.38 vs. 1.32, NS) during pimobendan. The new inotrope, pimobendan, exerted favourable long-term effects without haemodynamic or humoral signs of tolerance development.
H H Erlemeier; W Kupper; W Bleifeld
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European heart journal     Volume:  12     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-11-13     Completed Date:  1991-11-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  889-99     Citation Subset:  IM    
Department of Cardiology, University Hospital Eppendorf, Hamburg, Germany.
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MeSH Terms
Body Weight / drug effects
Creatinine / blood
Double-Blind Method
Enalapril / adverse effects,  therapeutic use*
Exercise Test
Heart Failure / drug therapy*,  physiopathology*
Hemodynamics / drug effects*
Middle Aged
Phosphodiesterase Inhibitors / therapeutic use*
Potassium / blood
Pyridazines / adverse effects,  therapeutic use*
Renin / blood
Reg. No./Substance:
0/Phosphodiesterase Inhibitors; 0/Pyridazines; 60-27-5/Creatinine; 74150-27-9/pimobendan; 7440-09-7/Potassium; 75847-73-3/Enalapril; EC

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