Hemodynamic and Neurohumoral Effects of Ibopamine in Patients with Chronic Congestive Heart Failure

Abstract

Ibopamine is a new, orally active dopamine-like drug with inotropic and vasoac-tive properties. With a predominant action on dopaminergic (DA) and β-receptors, ibopamine increases cardiac output, reduces peripheral vascular resistances and increases renal blood flow, exerting a lesser effect on preload parameters. This hemodynamic improvement is manifested in subjects with normal myocardium as well as in patients with heart failure in different stages of the syndrome including refractory heart failure, and it is also present after relatively long-term treatment without evidence of pharmacological tolerance. Probably in relation with DA₂ activation, ibopamine also modulates the neurohumoral consequences of heart failure with a decrease in plasma renin activity and norepinephrine and aldosterone plasma levels, both acutely and after chronic administration, an effect that can be beneficial in the long-term treatment of patients with chronic congestive heart failure.