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Beta-blockade with bucindolol in heart failure caused by ischemic versus idiopathic dilated cardiomyopathy

S L Woodley1, E M Gilbert, J L Anderson

  • 1Heart Failure Treatment Program, University of Utah School of Medicine, Salt Lake City.

Circulation
|December 1, 1991
PubMed

Insights

Bucindolol improved heart function in patients with heart failure, particularly those with idiopathic dilated cardiomyopathy. Ischemic dilated cardiomyopathy patients showed less improvement, suggesting varied responses to beta-blockade.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Investigated bucindolol, a nonselective beta-blocker with vasodilatory properties.
  • Focused on patients with congestive heart failure from ischemic (ISCDC) and idiopathic (IDC) dilated cardiomyopathy.

Purpose of the Study:

  • To evaluate the efficacy of bucindolol in patients with ISCDC and IDC.
  • To compare the treatment response between ISCDC and IDC subgroups.

Main Methods:

  • Double-blind, placebo-controlled trial over 12 weeks.
  • Randomized patients stratified by heart failure etiology (ISCDC vs. IDC).
  • Assessed heart failure severity using invasive and noninvasive methods at baseline and end of study.

Main Results:

  • Bucindolol significantly improved ejection fraction, left ventricular size, filling pressure, stroke work index, and reduced norepinephrine levels in the overall cohort.
  • Improvements were primarily driven by the IDC subgroup.
  • The ISCDC subgroup showed significant improvement only in left ventricular size.

Conclusions:

  • Beta-blockade with bucindolol elicits quantitatively different responses based on the underlying cause of heart muscle disease.
  • Treatment effects vary between ischemic and idiopathic dilated cardiomyopathy.
Abstract

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