A randomized crossover trial of levodopa in congestive heart failure

Leszek, Przemysław; Zieliński, Tomasz; Janas, Jadwiga; Brodzki, M; Klimkiewicz, H; Korewicki, J

doi:10.1016/s1071-9164(96)80037-6

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…Chronic use of Sinemet could have side effects, as observed in Parkinson disease in which dyskinesias develop (42). However, L-DOPA has been used to treat a variety of other diseases, such as restless leg syndrome (43), cardiovascular disease (44), and most recently as a therapy for age-related macular degeneration (ClinicalTrials.gov NCT03022318). Importantly, patients with Parkinson disease seem to be susceptible to the side effects of L-DOPA due to the loss of dopaminergic neurons in the substantia nigra, as well as a reduction in DA transporter (42) and dysfunctional N-methyl-D-aspartate receptors, which are important for normal DA metabolism (45).…”

Section: Discussionmentioning

confidence: 99%

Novel Detection and Restorative Levodopa Treatment for Preclinical Diabetic Retinopathy

Motz¹,

Chesler

Allen

et al. 2020

Diabetes

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Diabetic retinopathy (DR) is diagnosed clinically by directly viewing retinal vascular changes during ophthalmoscopy or through fundus photographs. However, electroretinography (ERG) studies in humans and rodents have revealed that retinal dysfunction is demonstrable prior to the development of visible vascular defects. Specifically, delays in dark-adapted ERG oscillatory potential (OP) implicit times in response to dim-flash stimuli (<21.8 log cd $ s/m 2) occur prior to clinically recognized DR. Animal studies suggest that retinal dopamine deficiency underlies these early functional deficits. In this study, we randomized individuals with diabetes, without clinically detectable retinopathy, to treatment with either low-or high-dose Sinemet (levodopa plus carbidopa) for 2 weeks and compared their ERG findings with those of control subjects (no diabetes). We assessed dim-flash-stimulated OP delays using a novel handheld ERG system (RETeval) at baseline and 2 and 4 weeks. RETeval recordings identified significant OP implicit time delays in individuals with diabetes without retinopathy compared with age-matched control subjects (P < 0.001). After 2 weeks of Sinemet treatment, OP implicit times were restored to control values, and these improvements persisted even after a 2-week washout. We conclude that detection of dim-flash OP delays could provide early detection of DR and that Sinemet treatment may reverse retinal dysfunction.

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Section: Discussionmentioning

confidence: 99%

Novel Detection and Restorative Levodopa Treatment for Preclinical Diabetic Retinopathy

Motz¹,

Chesler

Allen

et al. 2020

Diabetes

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Cohn¹

1996

Journal of Cardiac Failure

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Renal Effects of L-DOPA in Heart Failure

Grossman

Shenkar

Peleg

et al. 1999

Journal of Cardiovascular Pharmacology

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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 > or = 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 approximately 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.

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A randomized crossover trial of levodopa in congestive heart failure

Cited by 3 publications

References 35 publications

Novel Detection and Restorative Levodopa Treatment for Preclinical Diabetic Retinopathy

Novel Detection and Restorative Levodopa Treatment for Preclinical Diabetic Retinopathy

Editorial comment

Renal Effects of L-DOPA in Heart Failure

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