Premium
Pentoxifylline in ischemic, hypertensive and idiopathic‐dilated cardiomyopathy: effects on left‐ventricular function, inflammatory cytokines and symptoms
Author(s) -
Bahrmann Philipp,
Hengst Uta M.,
Richartz Babara M.,
Figulla Hans R.
Publication year - 2004
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2003.09.005
Subject(s) - medicine , pentoxifylline , ejection fraction , dilated cardiomyopathy , heart failure , cardiology , placebo , clinical endpoint , ace inhibitor , ischemic cardiomyopathy , cardiomyopathy , natriuretic peptide , angiotensin converting enzyme , clinical trial , blood pressure , pathology , alternative medicine
Tumor necrosis factor (TNF)‐α and interleukin‐6 (IL‐6) are significantly elevated in patients with congestive heart failure (CHF). Pentoxifylline, a xanthin‐derived agent, is known to inhibit the production of TNF‐α and IL‐6. Recent studies have shown that pentoxifylline produces an increase in ejection fraction, a decrease in left‐ventricular chamber size and an improvement in clinical status in patients with idiopathic‐dilated cardiomyopathy. Therefore, we studied the effects of pentoxifylline in ischemic, hypertensive and idiopathic‐dilated cardiomyopathy. Methods: Primary endpoint was left‐ventricular ejection fraction (LVEF) assessed by contrast 2D echocardiography. Secondary endpoints were concentrations of TNF‐α, IL‐6, brain natriuretic peptide, maximal oxygen uptake (VO 2 max ) assessed by cardiopulmonary exercise testing and Minnesota Living with Heart Failure Questionnaire score or New York Heart Association scale. Results: Forty‐seven patients (31.9% ischemic, 21.3% hypertensive, 10.6% ischemic and hypertensive, 36.2% idiopathic‐dilated cardiomyopathy) were randomly assigned to pentoxifylline 600 mg BID ( n =23) or placebo ( n =24) if they had a compensated CHF with a LVEF less than or equal to 40% and had taken their standard treatment consisting of angiotensin‐converting enzyme inhibitors, diuretics and β‐blockers for at least 3 months. Baseline demographic and clinical characteristics of each group were similar. Forty‐one patients completed the study protocol and were analysed for primary and secondary endpoints. After 6 months of treatment, LVEF was unchanged in the pentoxifylline group compared with placebo (29±7 to 33±10% vs. 27±9 to 34±9%, respectively, P =NS). Also the secondary endpoints did not significantly change during follow‐up. Conclusion: Additional treatment with pentoxifylline is neutral with regard to left‐ventricular function, inflammatory cytokines and symptoms in patients with ischemic, hypertensive and idiopathic‐dilated cardiomyopathy.