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Ursodeoxycholic acid improved peripheral blood flow, liver function in chronic HF patients
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Treatment with twice-daily ursodeoxycholic acid for 4 weeks improved peripheral blood flow and was well tolerated, according to results of a small study of patients with chronic HF.
For the prospective, double blind, placebo-controlled, crossover study, researchers randomly assigned 17 clinically stable men with chronic HF (NYHA Class II/III and left ventricular ejection fraction <45%) to 500 mg ursodeoxycholic acid or placebo twice daily for 4 weeks. A washout period of 4 weeks in which patients did not receive any medication followed before patients were assigned another 4 weeks of treatment with the opposite medication.
According to study results, ursodeoxycholic acid improved peak post-ischemic peak peripheral blood flow in the arm (18%; P=.038) vs. placebo. Researchers also found a trend for improved peak post-ischemic blood flow in the leg (17%; P=.079). After treatment with ursodeoxycholic acid, levels of gamma-glutamyl transferase, aspartate transaminase and soluble tumor necrosis factor alpha receptor-1 were lower vs. placebo (all P<.05), as well as absolute number of leukocytes, neutrophils and lymphocytes. No change was seen in the 6-minute walk test or NYHA class. Compared with placebo, levels of tumor necrosis factor alpha and interleukin-6 remained unchanged or increased.
“Von Haehling and colleagues have demonstrated that ursodeoxycholic acid therapy is feasible in a stable HF population, and the provocative finding of improved forearm endothelial function has paved the way for larger studies of safety and efficacy,” James M. McCabe, MD, of the division of cardiology at Brigham and Women’s Hospital, and John R. Teerlink, MD, of the San Francisco Veterans Affairs Medical Center and School of Medicine at the University of California, San Francisco, wrote in an accompanying editorial.
Disclosure: Several researchers report a financial interest in Amgen, AstraZeneca, Boehringer Ingelheim, the Falk Foundation, Fresenius, Intercept, Menarini, MSD, Pfizer, PsiOxus, Vifor and Servier. Drs. McCabe and Teerlink report no relevant financial disclosures.
For more information:
- McCabe JM. J Am Coll Cardiol. 2012;59:593-594.
- von Haehling S. J Am Coll Cardiol. 2012;59:585-592.