The effects of octreotide in dilated cardiomyopathy: an open-label trial in 12 patients.

Octreotide, a somatostatin analogue, has been found effective in the treatment of acromegalic cardiomyopathy. We investigated whether intermittent octreotide therapy had beneficial effects in patients with ischemic or idiopathic dilated cardiomyopathy, which are refractory to conventional therapy. Twelve patients with ischemic or idiopathic dilated cardiomyopathy were enrolled in the study. In addition to conventional treatment, octreotide (first 50 microg and then 25 microg three times per day for 4 days) was administered and repeated after 1, 2, and 3 months. The patients were evaluated 3 times, before and immediately after the first treatment and after 3 months of treatment, using echocardiography, exercise stress testing, ambulatory ECG, right ventricular catheterization, cardiac enzymes, and the Minnesota living with heart failure questionnaire for quality of life. There were no significant changes in parameters after the first treatment. However, after 3 months of treatment, there were significant improvements in the left ventricular ejection fraction, left ventricular posterior wall thickness, hemodynamics, exercise capacity, and quality of life. Additionally, ischemic burden and the number of ventricular premature beats also decreased slightly. Intermittent octreotide therapy led to significant improvements in patients with ischemic and idiopathic dilated cardiomyopathy refractory to conventional treatment. We believe that this therapy should be attempted as an adjunctive therapy in these patients, and that in this respect, randomized, double-blind, clinical, and large-scale studies are required before regular usage is undertaken.