Copyright © 1995 by the European Society of Cardiology.
© 1995 The European Society of Cardiology
The effects of ibopamine on glomerular filtration rate and plasma norepinephrine remain preserved during prolonged treatment in patients with congestive heart failure
,
*Department of Internal Medicine Netherlands
Department of Surgery, University Hospital Groningen Netherlands
Department of Cardiology, Division of Intensive Care Netherlands
revised 5 October 1994; accepted 28 October 1994.
Correspondence; Dr A. R. J. Girbes, Department of Surgery, Intensive Care Unit, University Hospital, Postbus 30001, 9700 RB Groningen, The Netherlands.
Abstract
In acute studies ibopamine, an aselective dopamine agonist, induces moderate increases of GFR and ERPF, and a fall in plasma norepinephrine levels in patients with congestive heart failure (CHF). We evaluated acute and chronic effects of ibopamine on renal haemodynamics, sodium excretion, PRA, plasma aldosterone (ALD) and norepinephrine levels in an open controlled study in 10 patients aged (51–79 years) with mild CHF, NYHA class II-IIL All patients used digoxin andfrusemide. After a control study day, the second study day involved the administration of 100 mg ibopamine. Subsequently the patients continued to take ibopamine 100 mg three times daily for one month, at which time the chronic effects were measured on the third study day.
Results: on the second study day ERPF rose from a baseline of 288 ± 32 to a mean of 308±32 ml. min–1. 1.73 m–2 (P<0.05) during the 4h after the first administration of ibopamine and GFR rose from 77±8 to a mean of 84±8 ml. min–1. 1.73 m–2 (P<0.05). The ratio GFR/ERPF, representing the filtration fraction (FF) remained unchanged. On the third study day GFR and ERPF at baseline were similar to those before ibopamine treatment. After the acute on chronic administration we observed an increase in GFR (from 76±6 to a mean of 85±7 ml. min–1. 17.3m–2 (P<0.05)), and in ERPF (from 27.9±27 to a mean of 29.3 ± 29 ml. min–1. 17.3 m–2 (P<0.05). Plasma norepinephrine levels fell from 2.63±0.48 to 1.92±0.27 nmol. l–1 (P<0.05) after the acute administration of ibopamine, and remained unchanged after the acute on chronic ibopamine administration (C: 1.80±0.42 nmol. l–1). No changes in sodium excretion were observed, either in blood pressure, heart rate, PRA or ALD. We conclude that renal function is preserved during chronic ibopamine treatment and the acute moderate increase of ERPF and GFR after a single dose of 100 mg of ibopamine is still present after one month of treatment with ibopamine in patients with CHF. Ibopamine lowered plasma norepinephrine levels in our patients with CHF, and these values remained unchanged after the acute on chronic administration of ibopamine.
Key Words: Renal plasma flow • glomerular filtration rate • filtration fraction • natriuresis • plasma renin activity • plasma aldosterone • plasma norepinephrine • ibopamine • congestive heart failure