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Ursodeoxycholic acid in patients with chronic heart failure: a double-blind, randomized, placebo-controlled,

Stephan von Haehling1, Joerg C Schefold, Ewa A Jankowska

  • 1Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany. stephan.von.haehling@web.de.

Journal of the American College of Cardiology
|February 4, 2012
PubMed

Insights

Ursodeoxycholic acid (UDCA) improved peripheral blood flow in patients with chronic heart failure (CHF). This study found UDCA well tolerated and beneficial for liver function markers in CHF patients.

Area of Science:

  • Cardiology
  • Hepatology
  • Pharmacology

Background:

  • Endothelial dysfunction is a key issue in chronic heart failure (CHF), limiting exercise capacity.
  • Bacterial lipopolysaccharide can exacerbate endothelial dysfunction via proinflammatory cytokine release.
  • Ursodeoxycholic acid (UDCA), used for liver disease, possesses anti-inflammatory properties and may mitigate lipopolysaccharide effects.

Purpose of the Study:

  • To evaluate the impact of ursodeoxycholic acid (UDCA) on endothelial function in chronic heart failure (CHF) patients.
  • To assess changes in inflammatory markers and peripheral blood flow following UDCA treatment in CHF.

Main Methods:

  • A prospective, randomized, double-blind, placebo-controlled crossover study was conducted.
  • 17 male patients with CHF (NYHA class II/III, LVEF <45%) received UDCA (500 mg BID) or placebo for 4 weeks each.
  • Primary endpoint: post-ischemic peak peripheral arm blood flow measured by strain-gauge plethysmography.

Main Results:

  • UDCA significantly improved peak post-ischemic arm blood flow by 18% (p=0.038) compared to placebo.
  • A trend towards improved leg blood flow was observed (+17%, p=0.079).
  • UDCA lowered liver enzymes (GGT, AST) and soluble TNFα receptor 1 (all p<0.05), indicating improved liver function.

Conclusions:

  • Ursodeoxycholic acid (UDCA) is safe and well-tolerated in chronic heart failure (CHF) patients.
  • UDCA demonstrates efficacy in improving peripheral blood flow in CHF.
  • The treatment is associated with beneficial effects on liver function markers in this population.
Abstract

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