Pharmacotherapeutic profile of ibopamine in heart failure

Heart failure is a complex cardiovascular syndrome affording many pharmacotherapeutic targets. Ibopamine affords a unique pharmacological profile for the treatment of this complex syndrome by virtue of its ability to stimulate DA-1 and DA-2 receptors in the vasculature in combination with its beta 2-agonist activity. The drug has been shown to improve the Frank-Starling relationship in the failing heart and augment cardiac output and ejection fraction at the same time that cardiac filling pressure is reduced. Concomitantly, the drug has been shown to attenuate the activated neuroendocrine responses activated in heart failure. Clinically, ibopamine has been shown to improve exercise tolerance, reduce the patient's symptom score, and NYHA classification, and reduce the requirement for additional anti-heart failure drugs. The influence of ibopamine on survival in heart failure awaits pragmatic tests, but the results of open monitoring studies are promising in this respect. Ibopamine does not appear to have any substantial adverse reactions that would inhibit its use in patients in heart failure. The unique pharmacotherapeutic profile of ibopamine affords a new pharmacologic vista for the treatment of patients with chronic heart failure.