EFFECTS OF PIMOBENDAN ON EXERCISE TOLERANCE AND QUALITY-OF-LIFE IN PATIENTS WITH HEART-FAILURE

There has been an intensive search for safe and clinically effective i notropic agents for use as adjunctive therapy in patients with advance d heart failure. Pimobendan is a benzimidazole-pyridazinone derivative with calcium-sensitizing properties that increases myocardial contrac tile force without increasing intracellular calcium. This review summa rizes the data from five controlled, randomized prospective trials of pimobendan that demonstrate significant improvements in exercise capac ity and quality of life in patients with heart failure. The clinical b enefits of pimobendan found in these trials contrast with the adverse experience noted previously with milrinone and enoximone. This may be related to the different mechanism of action of pimobendan or to a stu dy design that permitted examination of a lower dosage. These cumulati ve data suggest that pimobendan may have a useful adjunctive role in h eart failure and that further assessment of its effects on overall mor tality is needed.