EFFECTS OF HISTAMINE TYPE 2-RECEPTOR ANTAGONISTS CIMETIDINE AND FAMOTIDINE ON LEFT-VENTRICULAR SYSTOLIC FUNCTION IN CHRONIC CONGESTIVE-HEART-FAILURE

Twelve patients with stable congestive heart failure and left ventricu lar dysfunction were enrolled in a double-blind, randomized crossover trial of famotidine, cimetidine and placebo to determine whether hista mine type 2 (H2) antagonists adversely affect left ventricular systoli c performance. Two-dimensional echocardiograms were obtained at baseli ne, after 4 days of oral treatment with standard doses af famotidine a nd cimetidine, and placebo, and at the conclusion of the trial. The ba seline mean ejection fraction was 19 +/- 7%. The changes in ejection f raction were +2 +/- 11% (95% confidence interval [CI] -5 to 9%) with f amotidine, +3 +/- 10% (95% CI -3 to 10%) with cimetidine, and -3 +/- 7 % (95% CI -8 to 2%) with placebo. There were no significant difference s in changes in ejection fraction among the 3 experimental treatments (p = 0.22; analysis of variance). The changes in end-systolic wall str ess/volume ratios from baseline were +6 +/- 21% (95% CI -6 to 18%) for famotidine, +8 +/- 29% (95% CI -8 to 25%) for cimetidine, and +2% +/- 29% (95% CI -15 to 18%) for placebo (p = 0.69; analysis of variance). No patient had a worsening af symptoms during therapy. Despite previo us reports that H-2 antagonists may depress left ventricular systolic function, at standard doses these agents result in no decrease in left ventricular systolic function in patients with chronic congestive hea rt failure.