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Effect of oral H2-receptor antagonists on left ventricular systolic function and exercise capacity in patients with
B D Lucas1, M A Williams, S M Mohiuddin
1Center for Clinical Sciences Research, Division of Research, Camcare Health Education and Research Institute, Charleston, West Virginia, USA.
Insights
This study found that common H2-receptor antagonists like cimetidine, famotidine, and ranitidine do not significantly impact heart function or exercise ability in stable heart failure patients. These medications showed no adverse effects on left ventricular systolic function or aerobic capacity.
Area of Science:
- Cardiology
- Pharmacology
- Exercise Physiology
Background:
- Heart failure (HF) management often involves multiple medications.
- The impact of commonly used H2-receptor antagonists (H2RAs) on cardiovascular function in HF patients is not fully understood.
- H2RAs are frequently prescribed for gastrointestinal issues, even in patients with chronic conditions like heart failure.
Purpose of the Study:
- To investigate the effects of cimetidine, famotidine, and ranitidine on cardiac function and exercise performance in patients with stable heart failure.
- To compare the impact of these H2RAs against a placebo in a controlled clinical setting.
Main Methods:
- A double-blind, randomized, placebo-controlled, four-way crossover study was conducted.
- Twelve male patients with New York Heart Association class II or III stable heart failure participated.
- Participants received cimetidine, famotidine, ranitidine, or placebo for 7 days each, with a 1-week washout period between treatments.
Main Results:
- No significant changes were observed in left ventricular systolic function, aerobic metabolic performance, or exercise capacity with any of the H2RAs compared to placebo.
- All patients completed the study without reporting adverse effects.
- Placebo-subtracted differences for all measured parameters were not statistically significant for any of the tested agents.
Conclusions:
- Administering cimetidine, famotidine, or ranitidine for 7 days at standard clinical dosages does not significantly affect left ventricular systolic function, aerobic metabolic performance, or exercise capacity in men with stable heart failure (NYHA class II-III).
- These findings suggest that H2RAs can be safely used in this patient population without compromising cardiovascular or exercise parameters.
Study Objective:
To evaluate the effect of cimetidine, famotidine, ranitidine, and placebo on left ventricular systolic function, aerobic metabolic performance, and exercise capacity in patients with chronic, stable heart failure.
Design:
Double-blind, randomized, placebo-controlled, four-way crossover study.
Setting:
Outpatient, university-affiliated cardiology clinic.
Patients:
Twelve men with stable New York Heart Association class II or III heart failure secondary to ischemic heart disease or hypertension.
Interventions:
Patients received in random sequence cimetidine 400 mg twice/day, famotidine 40 mg/day, ranitidine 150 mg twice/day, and placebo. Each treatment was administered for 7 days, and the periods were separated by a 1-week washout.
Measurements And Main Results:
Before and after each treatment, patients underwent a bicycle stress echocardiogram with aerobic metabolic assessment. Left ventricular function was evaluated by calculating ejection phase indexes from Doppler echocardiographic measurements. All 12 patients successfully completed the study. No patient reported any adverse effect attributed to study drugs. None of the treatments was associated with significant changes in any measure of left ventricular systolic function, aerobic metabolic performance, or exercise capacity, nor were placebo-subtracted differences for the agents significantly different for any of the three measures.
Conclusion:
The three H2-receptor antagonists administered for 7 days at clinical dosages have no significant effect on left ventricular systolic function, aerobic metabolic performance, or exercise capacity in men with class II or III stable heart failure.