PMID- 9660578
OWN - NLM
STAT- MEDLINE
DCOM- 19980724
LR  - 20150616
IS  - 0140-6736 (Print)
IS  - 0140-6736 (Linking)
VI  - 351
IP  - 9109
DP  - 1998 Apr 11
TI  - Randomised investigation of effects of pentoxifylline on left-ventricular 
      performance in idiopathic dilated cardiomyopathy.
PG  - 1091-3
AB  - BACKGROUND: There is accumulating evidence that inflammatory cytokines have an 
      important role in the pathogenesis of heart failure. Plasma concentrations of 
      tumour necrosis factor alpha (TNF-alpha) are high in heart failure and have been 
      correlated with the severity of symptoms. Pentoxifylline suppresses the 
      production of TNF-alpha. This study aimed to assess the effects of pentoxifylline 
      on left-ventricular function and functional class in patients with idiopathic 
      dilated cardiomyopathy. METHODS: We undertook a single-centre, prospective, 
      double-blind, randomised, placebo-controlled trial, in which 28 patients with 
      idiopathic dilated cardiomyopathy were assigned pentoxifylline 400 mg three times 
      daily or matching placebo. Clinical, echocardiographic, and radionuclide 
      assessments were done at baseline and after 6 months of treatment. Primary 
      endpoints were New York Heart Association (NYHA) functional class and 
      left-ventricular function. FINDINGS: Baseline characteristics were similar in the 
      two groups. Four patients died during the study period, all in the placebo group. 
      After 6 months of treatment, the proportion of patients in NYHA functional class 
      I or II was higher in the pentoxifylline group than in the placebo group (14/14 
      vs 10/14; p=0.01), and ejection fraction was higher in the pentoxifylline group 
      than in the placebo group (mean 38.7% [SD 15.0] vs 26.8% [11.0], p=0.04). At 6 
      months, TNF-alpha plasma concentrations were significantly lower in the 
      pentoxifylline-treated group than in the placebo group (2.1 [1.0] vs 6.5 [5.0] 
      pg/mL, p=0.001). INTERPRETATION: Our results suggest that pentoxifylline improves 
      symptoms and left-ventricular systolic function in patients with idiopathic 
      dilated cardiomyopathy. These results must be confirmed in larger-scale trials.
FAU - Sliwa, K
AU  - Sliwa K
AD  - Department of Cardiology, Baragwanath Hospital, University of Witwatersrand, 
      Johannesburg, South Africa.
FAU - Skudicky, D
AU  - Skudicky D
FAU - Candy, G
AU  - Candy G
FAU - Wisenbaugh, T
AU  - Wisenbaugh T
FAU - Sareli, P
AU  - Sareli P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Lancet
JT  - Lancet (London, England)
JID - 2985213R
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 0 (Vasodilator Agents)
RN  - SD6QCT3TSU (Pentoxifylline)
SB  - IM
MH  - Cardiomyopathy, Dilated/blood/*physiopathology
MH  - Double-Blind Method
MH  - Female
MH  - Gated Blood-Pool Imaging
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pentoxifylline/*pharmacology
MH  - Prospective Studies
MH  - Tumor Necrosis Factor-alpha/analysis
MH  - Vasodilator Agents/*pharmacology
MH  - Ventricular Function, Left/*drug effects
EDAT- 1998/07/11 00:00
MHDA- 1998/07/11 00:01
CRDT- 1998/07/11 00:00
PHST- 1998/07/11 00:00 [pubmed]
PHST- 1998/07/11 00:01 [medline]
PHST- 1998/07/11 00:00 [entrez]
AID - S0140-6736(97)09338-0 [pii]
AID - 10.1016/S0140-6736(97)09338-0 [doi]
PST - ppublish
SO  - Lancet. 1998 Apr 11;351(9109):1091-3. doi: 10.1016/S0140-6736(97)09338-0.