Document Detail

Review of clinical experience with xamoterol. Effects on exercise capacity and symptoms in heart failure.
MedLine Citation:
PMID:  1967561     Owner:  NLM     Status:  MEDLINE    
The sympathetic nervous system becomes activated in heart failure, and while this is initially beneficial, the consequences of prolonged raised levels of catecholamines can be counterproductive. Xamoterol, a partial agonist that acts on the cardiac beta 1-adrenergic receptor, modifies the response of the heart to variations in sympathetic activity. At rest, it produces modest improvements in cardiac contractility, relaxation, and filling without increase in myocardial oxygen demand. The improvements are maintained during exercise although the attendant tachycardia is attenuated. The beneficial effects of xamoterol on both systolic and diastolic function suggested that it would be effective in patients with mild-to-moderate heart failure, and this was demonstrated in small placebo-controlled studies where effort tolerance and symptoms were improved. A large multicenter study program comprised of four studies demonstrated that patients with mild-to-moderate heart failure randomized to xamoterol (n = 617) 200 mg b.i.d. for 3 months significantly (p less than 0.0001) improved exercise capacity by 37% as compared with the placebo group (n = 300) with an increase of 18%. The xamoterol group also showed significant improvements in symptoms of breathlessness, fatigue, and life values as compared with the placebo group. In one of the multicenter studies in which 433 patients were randomized to xamoterol (n = 220), placebo (n = 109), and a positive control, digoxin 0.125 mg b.i.d. (n = 104), the percentages of improvement in exercise work were 33%, 5%, and 17%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
H F Marlow
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Review    
Journal Detail:
Title:  Circulation     Volume:  81     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1990 Feb 
Date Detail:
Created Date:  1990-03-13     Completed Date:  1990-03-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  III93-8     Citation Subset:  AIM; IM    
Medical Research Department, ICI Pharmaceuticals, Macclesfield Park, Cheshire, England.
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MeSH Terms
Adrenergic beta-Agonists / therapeutic use*
Double-Blind Method
Heart Failure / drug therapy*
Multicenter Studies as Topic
Myocardial Contraction / drug effects*
Propanolamines / therapeutic use*
Randomized Controlled Trials as Topic
Sympathetic Nervous System / drug effects
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Propanolamines; 81801-12-9/Xamoterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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