Therapy of Ischemic Cardiomyopathy with Pentoxifylline

Abstract

Abnormal blood rheology is a known characteristics of coronary artery disease. The authors evaluated the effects of pentoxifylline on the exercise capacity ejection fraction and symptoms of 9 patients with ischemic cardiomyopathy. All patients had signs and symptoms of left ventricular dysfunction. All had at least two major vessels obstructed as determined by coronary angiography. Pentoxifylline 400 mg three times daily was administered for twelve weeks. Seven of 9 patients responded with increases in ejection fraction and exercise tolerance. Exercise tolerance correlated with improvement or lack of improvement in ejection fraction. For all patients at twelve weeks post-therapy mean ejection fraction increased 9.8% over baseline (p = .07), total treadmill time increased 15% (p = .27), and mean double product increased 13% (p = .03). Anginal symptoms were significantly improved over baseline at twelve weeks of therapy (p greater than .001), as well as dyspnea on exertion (p = .03). Pentoxifylline was well tolerated. Pentoxifylline may benefit ischemic cardiomyopathy by improving coronary perfusion owing to favorable alterations in hemorheologic properties.

Pentoxifylline in ischemic, hypertensive and idiopathic‐dilated cardiomyopathy: effects on left‐ventricular function, inflammatory cytokines and symptoms

“…Cardiovascular disability assessed by LHFQ scores or NYHA scale did not change in both groups. These findings are in contrast to the results of various other studies [16–18,20,23]. Several studies have demonstrated that circulating BNP concentrations increase with the severity of CHF based on NYHA classification [28,29].…”

“…The mechanism of the underlying principle is yet not clearly understood. Barnett and Touchon showed that the clinical improvement of pentoxifylline is related to its haemorheological properties [20]. Sliwa hypothesized that the inhibition of phosphodiesterase activity by pentoxifylline led to the improvement in LVEF via increase in intracellular cyclic adenosine monophosphate and decrease in TNF‐α [16].…”

“…Consequently, the production of mediators like TNF‐α, IL‐6 and Fas/Apo‐1 is reduced [13–15]. Recent studies have shown that pentoxifylline produces an increase in ejection fraction, a decrease in left‐ventricular chamber size and an improvement in clinical status in patients with idiopathic‐dilated and ischemic cardiomyopathy [16–20]. Therefore, we studied the effects of pentoxifylline on left‐ventricular function, inflammatory cytokines and symptoms in ischemic, hypertensive and idiopathic‐dilated cardiomyopathy.…”

Allopurinol reduces antigen-specific and polyclonal activation of human T cells

“…Our results showed that allopurinol decreases iROS production by T cells which might have important therapeutic implications since down-regulation of inflammatory T cells is the treatment of choice for many inflammatory diseases. In agreement with this notion, the use of a different immunomodulating agent, Pentoxifylline, improved the clinical status of patients with idiopathic-dilated and ischemic cardiomyopathy (Barnett and Touchon, 1990; Skudicky et al, 2000; Sliwa et al, 2002, 2004). …”