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Effects of long-term xamoterol in idiopathic dilated cardiomyopathy
K Watanabe1, Y Hirokawa, K Suzuki
1Division of Cardiology, Tsubame Rosai Hospital, Niigata, Japan.
Insights
Xamoterol, a beta 1-partial agonist, improved heart function and symptoms in patients with idiopathic dilated cardiomyopathy (DCM). This adjunctive therapy showed better hemodynamics and a higher survival rate, suggesting a satisfactory prognosis with improved clinical parameters.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Idiopathic dilated cardiomyopathy (DCM) is a serious condition affecting heart muscle function.
- Conventional therapies for DCM include digitalis, diuretics, and vasodilators.
Purpose of the Study:
- To evaluate the efficacy of xamoterol as an adjunctive therapy in patients with idiopathic DCM.
- To assess the impact of xamoterol on hemodynamic parameters, exercise capacity, and survival rates.
Main Methods:
- A prospective study involving 26 patients with DCM receiving xamoterol (200 mg daily) alongside conventional treatment.
- Patients were monitored for an average of 35 months, with assessments including cardiothoracic ratio (CTR), left ventricular end-diastolic dimension (LVDD), ejection fraction (EF), and blood norepinephrine (NE) levels.
Main Results:
- Xamoterol therapy led to a decrease in CTR, LVDD, and exercise heart rate, alongside an increase in exercise duration, fractional shortening (FS), and EF.
- Significant improvements were observed in survivors regarding NE, LVDD, FS, EF, and pulmonary capillary wedge pressure (PCWP).
- The 3-year survival rate was 83%, with 12 out of 20 patients improving their NYHA functional class.
Conclusions:
- Adjunctive xamoterol therapy demonstrates beneficial effects on hemodynamics and symptoms in DCM patients.
- Improvement in key parameters like NE, LVDD, FS, EF, and PCWP during xamoterol treatment indicates a potentially satisfactory prognosis.
Abstract:
In prospective study, the beta 1-partial agonist xamoterol (200 mg daily) was given to 26 patients with idiopathic dilated cardiomyopathy (DCM) in addition to conventional therapy with digitalis, diuretics and vasodilators. The patients were followed for 35 +/- 15 months (6-53 months). Cardiothoracic ratio (CTR), left ventricular end-diastolic dimension (LVDD) and exercise heart rate decreased, and exercise duration, fractional shortening (FS) and ejection fraction (EF) increased after xamoterol therapy. Twenty-one patients survived and one patient dropped out at 7 months. Twelve of the 20 patients improved their NYHA functional class. Blood norepinephrine concentration (NE), LVDD, FS, EF and pulmonary capillary wedge pressure (PCWP) after xamoterol were significantly better in survivors than in non-survivors. Survival rate at 3 years was 83%. The results suggest that adjunctive xamoterol therapy in DCM has a beneficial effect on hemodynamics and symptoms. Prognosis will be satisfactory if improvement in parameters such as NE, LVDD, FS, EF and PCWP is seen during xamoterol therapy.