[Treatment of severe congestive heart failure with the beta-agonist fenoterol (author's transl)].

The acute hemodynamic effects of the semiselective beta 2-stimulating compound Fenoterol were studied in 7 patients with severe congestive heart failure (IV NYHA) as a result of a low-output-syndrome of varying aetiology (coronary heart disease/cardiomyopathy). The continuous infusion of Fenoterol (2.5 micrograms/min for 60 min) induced the following changes in parameters of pump function: a slight but not yet significant fall of PCPm which we considered as a reference value of LVEDP from 24 +/- 9 to 20 +/- 6 mm Hg (13%); a highly significant increase in CI from 1.96 +/- 04 to 2.71 +/- 0.53 l/min . m2 (39%; p less than 0.001) and in SVI from 18.7 +/- 4.9 to 24.8 +/- 8.1 ml/m2 (32%; p less than 0.01); a clear reduction of TPR from 1374 +/- 427 to 977 +/- 282 dyn . s . cm-5 (28%; p less than 0.001). PVR was reduced from 245 +/- 158 to 192 +/- 85 dyn . s . cm-5 (n.s.). There were no significant changes in right ventricular filling pressure (15 +/- 8 to 15 +/- 9 mm Hg), mean arterial pressure (76 +/- 17 to 75 +/- 16 mm Hg) and heart rate (107 +/- 13 to 117 +/- 23 beats/min). The study indicates that the "selective" beta 2-agonist Fenoterol in severe congestive heart failure produces a significant improvement in pump function. We assume the increase in SV to be due to a positive inotropic effect -- caused by beta 1-stimulation -- and a reduction of impedance to left ventricular ejection by decrease in TPR -- caused by beta 2-stimulation. Thus Fenoterol seems to be useful in treatment of severe congestive heart failure with elevated TPR.