The use of levodopa, an oral dopamine precursor, in congestive heart failure

The successful treatment of congestive heart failure with intravenous dopamine in the acute setting has prompted investigation into the development and use of oral dopamine analogs. The administration of dopamine can lead to an improvement in myocardial pump performance through a combination of afterload reduction and augmented contractile state. The ingestion of levodopa, an oral dopamine precursor, is associated with sustained hemodynamic and clinical improvement in patients with congestive heart failure. Improvements in hemodynamic performance correlated with the generation of substantial amounts of dopamine. Current research efforts are directed at developing oral dopamine analogs that exhibit improved bioavailability and do not traverse the blood-brain barrier.