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 16 cases who received allopurinol (100 mg/day on the first three days, 200 mg/day on the second three days, and 300 mg/day (in case the patient could tolerate) for one month until the end of the study). The control group included 15 patients who received the same amount of placebo. LEVF was measured by echocardiography using Simpsonʹs 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 38.8% ± 9.9% and 41.9%± 9.7%, respectively (P < 0.05). The corresponding values in the control group were 37.05% ± 5.7% and 37.1% ± 5.6 % (P > 0.05). Mean changes related to ventricular ejection fraction in the group treated with allopurinol (3.1%± 5.6%) were significantly higher than those of the placebo group (0.05%± 0.3%) (P < 0.05). In addition, LVEF increased by 3.1% 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.