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Clinical efficacy and safety of pimobendan in treatment of heart failure--experience in Japan.

The results of Japanese studies on the clinical efficacy and safety of pimobendan in the treatment of heart failure are summarized in this paper. In patients with acute heart failure, a single oral 2.5 mg dose of pimobendan produced a significant increase in cardiac index (27.9%) and stroke volume index (24.4%), as well as a significant decrease in pulmonary capillary wedge pressure (-21.3%). A single oral 5.0 mg dose of pimobendan increased anaerobic threshold during exercise (7.3%). In a multicentre, placebo-controlled, double-blind trial, 8 weeks of treatment with pimobendan 2.5 mg b.i.d., which was suggested to be the optimal dose in a preceding dose-finding study, definitely improved symptoms and signs of heart failure in 52.6% of patients, and New York Heart Association function class in 64.1% of patients. This regimen was also associated with a significantly greater increase in physical activity than placebo. Furthermore, another double-blind, placebo-controlled study suggested that pimobendan 1.25 mg and 2.5 mg b.i.d. may have long-term beneficial effects on morbidity and quality of life in patients with chronic heart failure. Adverse reactions developed in 26 of 241 (10.8%) patients receiving multiple doses of pimobendan, but none of the reactions were serious. It is concluded that pimobendan may be useful in the treatment of patients with heart failure.