TY - JOUR
T1 - Renal effects of L-DOPA in heart failure
AU - Grossman, Ehud
AU - Shenkar, Alla
AU - Peleg, Edna
AU - Thaler, Michael
AU - Goldstein, David S.
PY - 1999/6
Y1 - 1999/6
N2 - We examined whether low-dose L-DOPA treatment induces natriuresis and diuresis in patients with congestive heart failure who have cardiac decompensation despite treatment with digoxin, a diuretic, and an angiotensin-converting enzyme inhibitor and who respond acutely to intravenously infused dopamine. In a randomized, double-blind, placebo- controlled crossover study, 11 patients with severe congestive heart failure received L-DOPA (0.10 g, p.o., t.i.d., for 1 day and then 0.25 g, p.o., t.i.d., for 2 days after a washout period of ≥ 1 day), with assessments of plasma and urinary levels of catechols, urinary volume, and sodium content, and clinical and laboratory measures of improvement of congestive heart failure. L-DOPA elicited short-term, dose-related increases in urinary volume and sodium excretion. At the 0.10-g dose, L-DOPA increased plasma L-DOPA levels and urinary, L-DOPA excretion by about fivefold, whereas at the 0.25- g dose, L-DOPA increased plasma and urinary L-DOPA by >50-fold. Twenty-four- hour urinary dopamine excretion increased by about fivefold after the low dose of L-DOPA and ~50-fold after the high dose. The results demonstrate that oral L-DOPA treatment can produce beneficial natriuretic and diuretic effects in selected patients with congestive heart failure. The bioavailability of oral L-DOPA appears to vary with the dose. These results support findings from previous studies about beneficial cardiac functional effects of L-DOPA in patients with refractory heart failure.
AB - We examined whether low-dose L-DOPA treatment induces natriuresis and diuresis in patients with congestive heart failure who have cardiac decompensation despite treatment with digoxin, a diuretic, and an angiotensin-converting enzyme inhibitor and who respond acutely to intravenously infused dopamine. In a randomized, double-blind, placebo- controlled crossover study, 11 patients with severe congestive heart failure received L-DOPA (0.10 g, p.o., t.i.d., for 1 day and then 0.25 g, p.o., t.i.d., for 2 days after a washout period of ≥ 1 day), with assessments of plasma and urinary levels of catechols, urinary volume, and sodium content, and clinical and laboratory measures of improvement of congestive heart failure. L-DOPA elicited short-term, dose-related increases in urinary volume and sodium excretion. At the 0.10-g dose, L-DOPA increased plasma L-DOPA levels and urinary, L-DOPA excretion by about fivefold, whereas at the 0.25- g dose, L-DOPA increased plasma and urinary L-DOPA by >50-fold. Twenty-four- hour urinary dopamine excretion increased by about fivefold after the low dose of L-DOPA and ~50-fold after the high dose. The results demonstrate that oral L-DOPA treatment can produce beneficial natriuretic and diuretic effects in selected patients with congestive heart failure. The bioavailability of oral L-DOPA appears to vary with the dose. These results support findings from previous studies about beneficial cardiac functional effects of L-DOPA in patients with refractory heart failure.
KW - Congestive heart failure
KW - Diuresis
KW - Dopamine
KW - L-DOPA
KW - Natriuresis
UR - http://www.scopus.com/inward/record.url?scp=0033015182&partnerID=8YFLogxK
U2 - 10.1097/00005344-199906000-00013
DO - 10.1097/00005344-199906000-00013
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C2 - 10367596
AN - SCOPUS:0033015182
SN - 0160-2446
VL - 33
SP - 922
EP - 928
JO - Journal of Cardiovascular Pharmacology
JF - Journal of Cardiovascular Pharmacology
IS - 6
ER -