Beneficial effects of pentoxifylline in patients with idiopathic dilated cardiomyopathy treated with angiotensin-converting enzyme inhibitors and carvedilol - Results of a randomized study

Article

关键词: TUMOR-NECROSIS-FACTOR;    LEFT-VENTRICULAR FUNCTION;    CHRONIC HEART-FAILURE;    NITRIC-OXIDE;    FAS LIGAND;    APOPTOSIS;    EXPRESSION;    DEATH;    OXPENTIFYLLINE;    VESNARINONE;   

DOI  :  10.1161/01.CIR.103.8.1083

来源: SCIE

【 摘 要 】

Background-We previously reported beneficial effects of pentoxifylline, a xanthine-derived agent known to inhibit the production of tumor necrosis factor-alpha, in patients with idiopathic dilated cardiomyopathy treated with diuretics, digoxin, and ACE inhibitors, Since then, 3 large clinical trials showed important clinical benefits of P-blockers in this population. Therefore, we designed the present study to establish whether in patients with heart failure already receiving treatment with ACE inhibitors and beta -blockers, the addition of pentoxifylline would have an additive beneficial effect. Methods and Results-In a single-center, prospective, double-blind, randomized, placebo-controled study, 39 patients with idiopathic dilated cardiomyopathy were randomized to pentoxifylline 400 mg TLD (n=20) or placebo (n=19) if they had a left ventricular ejection fraction <40% after 3 months of therapy with digoxin, ACE inhibitors, and carvedilol. Primary end points were New York Heart Association functional class, exercise tolerance, and left ventricular function, Patients were followed up for 6 months. Five patients died (3 in the placebo group). Patients treated with pentoxifylline had a significant improvement in functional class compared with the placebo group (P=0.01), with an increment in exercise rime from 9.5+/-5 to 12.3+/-6 minutes (P=0.1). Left ventricular ejection fraction improved from 24+/-9% to 31+/-13%, P=0.03, in the treatment group. Conclusions-In patients with idiopathic dilated cardiomyopathy, the addition of pentoxifylline to treatment with digoxin, ACE inhibitors, and carvedilol is associated with a significant improvement in symptoms and left ventricular function.

【 授权许可】

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