Effects of allopurinol on ventricular ejection fraction in patients with left ventricular failure

BACKGROUND: Efficiency of xanthine oxidase inhibitors on myocardial contractility is not clearly known. This study was conducted to determine the effects of allopurinol on left ventricular ejection fraction (LVEF) in patients with left ventricular failure. METHODS: In a randomized, double-blind, placebo-controlled clinical trial, the efficiency of allopurinol in the LVEF status was examined in two groups of patients suffering from class II or III ventriculur  failure according to the New York Heart Association classification. The intervention group consisted of ۱۶ cases who received allopurinol (۱۰۰ mg/day on the first three days, ۲۰۰ mg/day on the second three days, and ۳۰۰ mg/day (in case the patient could tolerate) for one month until the end of the study). The control group included ۱۵ patients who received the same amount of placebo. LEVF was measured by echocardiography using Simpson's method before the beginning and after the end of the intervention. RESULTS: The mean LVEF values before and after the intervention in the case group were ۳۸.۸ ± ۹.۹ and ۴۱.۹ ± ۹.۷, respectively (P < ۰.۰۵). The corresponding values in the control group were ۳۷.۰۵ ± ۵.۷ and ۳۷.۱ ± ۵.۶ (P > ۰.۰۵). Mean changes related to ventricular ejection fraction in the group treated with allopurinol (۳.۱ ± ۵.۶) were significantly higher than those of the placebo group (۰.۰۵ ± ۰.۳) (P < ۰.۵). In addition, LVEF increased by ۳.۱% of the base level in the intervention group. CONCLUSION: This study demonstrated that allopurinol prescription can improve LVEF in patients suffering from left ventricular failure to some extent. In fact, its clinical efficacy needs to be approved by more trials in various situations and longer treatment periods. KEYWORDS: Heart Failure, Left Ventricular Ejection Fraction, Xanthine Oxidase Inhibitors, Allupporinol, Clinical Trial