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Intravenous dopexamine in the treatment of acute congestive heart failure: Results of a multicenter, double-blind, placebo-controlled withdrawal study

  • Congestive Heart Failure
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Summary

Acute hemodynamic effects of intravenous infusion of dopexamine were evaluated by a placebo-controlled withdrawal study in patients with acute congestive heart failure. Twenty patients were enrolled at 10 centers in Japan. All patients had a pulmonary capillary or diastolic pressure of 15 mmHg or greater and a cardiac index of 2.5 l/min/m2 or less.Phase I: Intravenous dopexamine was introduced in a single-blind, uncontrolled fashion at the rate of 0.5 µg/kg/min and was titrated up to achieve a 30% or more increase in the cardiac index. Two patients withdrew from the study due to sinus tachycardia and ventricular ectopy or exacerbation of heart failure.Phase II: The remaining 18 responders who were free of limiting side effects were randomized in double-blind fashion to continue dopexamine or to switch to placebo for an additional 60 minutes. At the end of phase II, the hemodynamic improvement obtained in phase I of the study disappeared completely after substitution of placebo but was maintained in dopexamine-treated patients. Our findings suggest that dopexamine, when given in appropriate doses to selected patients, shows balanced vasodilator action suitable for the treatment of acute congestive heart failure.

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Authors and Affiliations

  1. The Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, 930-01, Toyama, Japan

    Hidetsugu Asanoi M.D.

  2. Kyoto University, Kyoto

    Shigetake Sasayama

  3. The University of Tokyo, Tokyo

    Tsunetaro Sakurai

  4. Fukui Medical School, Fukui

    Jong-Dae Lee

  5. Shiga University of Medical Science, Ohtsu

    Masahiko Kinoshita

  6. Kitano Hospital, Osaka

    Takao Ishimura

  7. Kobe City General Hospital, Kobe

    Jun-ichi Yoshikawa

  8. Kurashiki Central Hospital, Kurashiki

    Kazuaki Mitsudo

  9. Hiroshima City Hospital, Hiroshima

    Hikaru Sato

  10. Shimane Medical University, Izumo

    Shigefumi Morioka

  11. Kokura Memorial Hospital, Kitakyusyu

    Masakiyo Nobuyoshi

  12. Kumamoto University School of Medicine, Kumamoto

    Hirofumi Yasue

Authors
  1. Hidetsugu Asanoi M.D.
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  2. Shigetake Sasayama
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  3. Tsunetaro Sakurai
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  4. Jong-Dae Lee
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  5. Masahiko Kinoshita
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  6. Takao Ishimura
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  7. Jun-ichi Yoshikawa
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  8. Kazuaki Mitsudo
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  9. Hikaru Sato
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  10. Shigefumi Morioka
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  11. Masakiyo Nobuyoshi
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  12. Hirofumi Yasue
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the Investigators of the Dopexamine Multicenter Study

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See Appendix 1 for complete list of participating centers and principal investigators

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Asanoi, H., Sasayama, S., Sakurai, T. et al. Intravenous dopexamine in the treatment of acute congestive heart failure: Results of a multicenter, double-blind, placebo-controlled withdrawal study. Cardiovasc Drug Ther 9, 791–797 (1995). https://doi.org/10.1007/BF00879873

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  • DOI: https://doi.org/10.1007/BF00879873

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