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[Effects of xamoterol in moderate cardiac insufficiency]
J G Kayanakis1, L Larouchi, P Doat
1Clinique cardiologique Paulmy, Bayonne.
Insights
Xamoterol, a beta 1-adrenoceptor partial agonist, improved chronic heart failure symptoms and exercise capacity in a 3-month trial. Long-term use showed sustained benefits without tachyphylaxis, indicating its potential as a cardiotonic drug.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Chronic heart failure (CHF) remains a significant clinical challenge.
- Beta-1 adrenoceptor modulation is a therapeutic target for heart failure.
Purpose of the Study:
- To evaluate the efficacy and safety of xamoterol as a cardiotonic drug in patients with moderate chronic heart failure.
- To assess the clinical and hemodynamic effects of xamoterol compared to placebo over 3 months and its long-term effects over one year.
Main Methods:
- A double-blind, placebo-controlled trial of 3 months followed by a 1-year open-label phase.
- 10 patients with moderate chronic heart failure (NYHA class II-III) were enrolled.
- Clinical status (NYHA class), exercise response, hemodynamic parameters (pulmonary wedge pressure, left ventricular stroke work), and double product were assessed.
Main Results:
- Patients receiving xamoterol showed significant clinical improvement, with a one-class downgrading in NYHA classification compared to placebo.
- A significant increase in exercise response and improvements in hemodynamic parameters, including reduced pulmonary wedge pressure and increased left ventricular stroke work, were observed.
- The double product on exercise was reduced, indicating improved cardiac efficiency. No tachyphylaxis was observed during long-term use, with minimal side effects.
Conclusions:
- Xamoterol demonstrates significant clinical and hemodynamic benefits in patients with moderate chronic heart failure.
- The drug is well-tolerated and does not appear to induce tachyphylaxis with long-term administration.
- Xamoterol shows promise as an effective cardiotonic agent for managing chronic heart failure.
Abstract:
Xamoterol, a partial agonist of beta 1-adrenoceptors, was tested as a cardiotonic drug in 10 patients with moderate chronic heart failure. The trial was double-blind drug versus placebo for 3 months and open for one year. At 3 months the patients were clinically improved with downgrading by one NYHA class, and there was a significant increase in response to a 36-second exercise, as compared with the placebo group. Haemodynamic index, a 14 per cent fall in pulmonary wedge pressure and a 7 per cent increase in left ventricular stroke work as compared with the placebo group. This clinical and haemodynamic improvement was paralleled by a reduction of the double product on exercise. In long term use, xamoterol did not seem to induce tachyphylaxis, and few side-effects were recorded during this trial.