Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ibopamine is an active dopamine analogue leading to improved renal perfusion and afterload reduction in heart failure. This report describes casuistic experiences in patients with severe heart failure awaiting heart transplantation. All patients could be stabilized, intravenous catecholamines be discontinued, and diuretics be reduced. Six of seven patients could be successfully transplanted. No major side effects were noted. Thus ibopamine can be a suitable adjunct for patients with endstage heart failure.
 ...
PMID:Ibopamine as a valuable adjunct and substitute for dopamine in bridging therapy before heart transplantation. 128 70

To evaluate the attenuation of the effectiveness of long-term ibopamine therapy, ibopamine was administered in single doses of 100 and 200 mg to 10 patients with chronic heart disease. The hemodynamic studies using Swan-Ganz catheter and pharmacokinetic studies were carried out. Ibopamine was found to increase cardiac output and stroke index and to decrease systemic vascular resistance in this acute study. Six patients underwent long-term therapy with the drug and were evaluated for the development of tolerance. Three out of 5 patients experienced an improvement in NYHA functional class after 12-23 weeks of treatment. There was no attenuation in the effects of ibopamine on hemodynamics, pharmacokinetic parameters remained almost unchanged, and tolerance was not observed. These results suggest that ibopamine is useful as an orally administered anti-heart failure drug.
 ...
PMID:Hemodynamic effects and pharmacokinetics of long-term therapy with ibopamine in patients with chronic heart failure. 145 Nov 23

This review discusses the localization of adrenergic- and dopaminergic-adrenoceptors within the cardiovascular system and describes the cardiovascular and renal changes produced following the activation of these receptors by appropriate agonists. Whereas the role of alpha- and beta-adrenergic agents in the treatment of heart failure is well recognized, recent studies with dopamine (DA)-receptor agonists indicate that they offer a novel approach in the therapy of congestive heart failure. DA-adrenoceptor agonists reduce afterload by causing vasodilation and promote sodium excretion via direct activation of DA1-adrenoceptors located on renal tubules. Fenoldopam is a selective DA1-adrenoceptor agonist found to be effective in heart failure. It reduces afterload by causing peripheral vasodilation and produces natriuresis and diuresis. Dopexamine is a DA1- and beta 2-adrenoceptor agonist, and its efficacy in heart failure is due to its ability to provide mild inotropic support and cause a reduction in afterload. Ibopamine is a prodrug that is converted into its active metabolite, epinine. This compound activates primarily DA1- and DA2-adrenoceptors. It is effective in heart failure, and the mechanism progresses via DA1- and DA2-adrenoceptor-mediated reduction in afterload. Agonists of DA2-adrenoceptors reduce afterload by decreasing the release of norepinephrine and by reducing the levels of renin-angiotensin-aldosterone system. Since both of these systems are active in heart failure, ibopamine offers a rational approach for therapy. The present review addresses the concept of pharmacologic intervention in adrenergic and dopaminergic influence in the cardiovascular and renal systems to produce changes that are desirable for the pharmacotherapy of congestive heart failure.
 ...
PMID:Cardiovascular pharmacology of adrenergic and dopaminergic receptors: therapeutic significance in congestive heart failure. 167 49

Ibopamine is an orally active derivative of dopamine (DA) which metabolizes to its active form, epinine. Epinine is one of the few catecholamines that possess dopaminergic--DA1 and DA2--activity, alpha 1, alpha 2, beta 1, and beta 2 activity, with indirect sympathomimetic action of dopamine. Ibopamine increased positive dP/dt, stroke volume, aortic blood flow, renal blood flow, and diuresis in animals. In healthy volunteers and patients with heart failure, a single oral dose of ibopamine showed primary vasodilating action (postsynaptic DA1 activity and presynaptic DA2 activity). Following a single oral dose of 100 or 200 mg of ibopamine, the plasma concentration of epinine reached its peak within 30 minutes, and declined rapidly so that concentration was not detectable after 1.5-3 hours. Pharmacokinetics and hemodynamic effects in congestive heart failure patients are also discussed.
 ...
PMID:Clinical pharmacology of ibopamine. 167 50

Ibopamine is a dopamine-like drug that shows mainly vasoactive properties, predominantly acting on dopamine1-(DA1-) and DA2-adrenoceptors. Ibopamine increases cardiac output, reduces peripheral vascular resistance, and increases renal blood flow, exerting a lesser effect on preload parameters. This hemodynamic improvement is also present even after relatively long-term treatment. There is no evidence of pharmacologic tolerance. In relation to DA2-activation, ibopamine modulates the neurohumoral consequences of heart failure with decreases in plasma renin activity and aldosterone and norepinephrine plasma levels, an effect that can be beneficial in the long-term treatment of heart failure patients.
 ...
PMID:Ibopamine in chronic congestive heart failure: hemodynamic and neurohumoral effects. 167 51

Efficacy and safety of a drug are essential criteria to be fulfilled before a new drug receives recommendation. This review focuses on the safety of ibopamine in the treatment of chronic heart failure. Ibopamine is a new, orally active drug with a predominant action on dopaminergic adrenoceptors. As a result, it reduces systemic vascular resistance, increases cardiac output, and increases renal flow. Ibopamine also modulates the neuroendocrine reflexes in heart failure; plasma renin activity and norepinephrine and aldosterone plasma concentrations are reduced, both immediately and during sustained administration. Ibopamine has proved to be safe in many thousands of heart failure patients during long-term therapy. This argues well for its use as an alternative or additive therapy in the treatment of patients with chronic heart failure.
 ...
PMID:Ibopamine in the treatment of heart failure. 167 52

Ibopamine (IP) is a novel dopamine analogue for which beneficial effects have been shown in chronic heart failure. Hemodynamic effects of the substance include an increase in cardiac output and a decrease in the peripheral resistance. Aside from these hemodynamic effects, changes in renal (increased diuresis) and neurohumoral parameters (decreased plasma renin activity, aldosterone, norepinephrine, increased ANF and cGMP) have been found. The renal effects may originate from three independent mechanisms: 1) direct impact of improved hemodynamic parameters on the renal perfusion; 2) the improved cardiac performance results in a reduction of compensatory hormonal adaptations, such as the activation of the renin-angiotensin-aldosterone-axis or the sympathetic system; 3) direct effects on the intrarenal hemodynamic and glomerular/tubular functions induced by stimulation of renal dopaminergic receptors. The continued decrease of the plasma renin activity by 35% results in a reduction of the plasma levels of angiotensin II and aldosterone. Additionally, an increase in plasma atrial natriuretic factor (ANF) and its second messenger cyclic guanosine monophosphate (cGMP) was observed after ibopamine, which could contribute to the diuretic action of the drug. These findings underline the importance of extrarenal effects of a drug in the treatment of heart failure, this may essentially contribute to the improvement of cardiac performance, independent of positive inotropy.
 ...
PMID:[Ibopamine--acute hemodynamic, renal and neurohumoral effects]. 168 94

Recently, major advances have been made in the therapy of chronic congestive heart failure. New vasodilatory and positive inotropic drugs as well as specific antagonists to activated neurohormones have added new therapeutic dimensions. Dopaminergic stimulation, which has been used in acute heart failure for many years has now been introduced with the new substance ibopamine into the therapy of chronic heart failure. The therapeutic efficacy of new drugs in the treatment of chronic congestive heart failure has to be evaluated in terms of their prognostic and therapeutic impact for improvement and symptomatology, which sometimes does not necessarily lead to improvement of prognosis. Ibopamine has potential in improving prognosis by its major effects: vasodilatation, decrease in vasoactive hormones and improvement in renal blood flow and water diuresis. In the long-term therapy of chronic congestive heart failure ibopamine has been useful in mobilization of edema in acute decompensation, improvement of symptoms according to the New York Heart Classification and of exercise tolerance. In addition improvement of hemodynamics with an increase in cardiac output, a decrease in filling pressures and in peripheral resistance has been demonstrated. Efficacy of diuretics is improved and ibopamine has been a valuable adjunct in the pre-operative therapy before cardiac transplantation. Major positive inotropic effects in the usual dose of 100 mg tid, as well as other potentially dangerous effects of beta-receptor-stimulation (such as malignant, ventricular arrhythmias) can be largely excluded. Historically, controls of patients with heart failure of similar severity do not suggest any unfavorable effect of this drug on prognosis.
 ...
PMID:[Ibopamine--clinical results]. 168 95

Loss of myocardial contractility, reflexly enhanced vasoconstriction, and neuroendocrine excitation are the pathophysiologic hallmarks of low-output heart failure. Drugs that counter both consequences afford considerable therapeutic potential in retarding and perhaps even in staying the consequences of the syndrome. Ibopamine possesses such potential through its unique ability to stimulate both dopaminergic- and beta-adrenoreceptors in the heart and circulatory system. Stimulation of dopaminergic- receptors and beta 2-adrenoreceptors results in vasodilatation in all regional vascular territories. beta 2-Adrenoreceptor agonist activity also affords mild positive inotropic activity in the heart, whereas stimulation of presynaptic dopaminergic- receptors (DA2) attenuates the increased sympathetic neural outflow. The drug also suppresses the renin-angiotensin-aldosterone system in addition to having a direct natriuretic activity. The pharmacodynamic effects of ibopamine, exerted through its metabolite epinine, are translated into measurable therapeutic benefits in patients with chronic heart failure. The increase in peripheral blood flow induced in all regional vascular territories, including the kidneys, is associated with increased cardiac output and stroke volume and reduction in left ventricular pressure work, wall stress, and myocardial oxygen consumption. Plasma norepinephrine, angiotensin, and aldosterone are also reduced, and renal sodium excretion is enhanced. These hemodynamic and neuroendocrine activities, which are not subject to tolerance during sustained administration of the drug, are accompanied by clinically significant improvement in symptoms, exercise tolerance, and the New York Heart Association classification of disability. More important, no proarrhythmic effects have been observed during sustained treatment, and the minimal side effects observed during long-term treatment enhance the safety profile of the drug.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Efficacy of ibopamine in the treatment of heart failure. 197 82

Patients with heart failure exhibit a high prevalence of both ventricular and supraventricular arrhythmias, and the ventricular arrhythmias are characterized by multiform, bigeminal and paired beats as well as nonsustained ventricular tachycardia. The prognosis of heart failure is severe and approximately half of the patients die suddenly. In view of the high prevalence of arrhythmias in heart failure and the complex ventricular arrhythmias, it is important to consider the effect of antifailure treatment on such arrhythmias. Dopaminergic drugs represent one interesting therapeutic alternative. Ibopamine is an orally active dopaminergic substance and acts mainly as a vasodilator in patients with heart failure. According to published investigations on ibopamine in heart failure, this drug does not seem to have a proarrhythmic effect.
 ...
PMID:Effect of ibopamine, a dopamine congener, on arrhythmias in heart failure. 198 Jun 32


1 2 3 4 Next >>