Τίτλος:
The long-term survival benefit conferred by intermittent dobutamine
infusions and oral amiodarone is greater in patients with idiopathic
dilated cardiomyopathy than with ischemic heart disease
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Intermittent dobutamine infusions (IDI) combined with oral
amiodarone improve the survival of patients with end-stage congestive
heart failure (CHF). The purpose of the present study was to evaluate
whether the response to long-term treatment with IDI+amiodarone is
different in patients with ischemic heart disease (IHD) versus
idiopathic dilated cardiomyopathy (IDC).
Methods: The prospective study population consisted of 21 patients with
IHD (the IHD Group) and 16 patients with IDC (the IDC Group) who
presented with decompensated CHIF despite optimal medical therapy, and
were successfully weaned from an initial 72-h infusion of dobutamine.
They were placed on a regimen of oral amiodarone, 400 mg/day and weekly
IDI, 10 mu g/kg/min, for 8 h.
Results: There were no differences in baseline clinical and hemodynamic
characteristics between the 2 groups. The probability of 2-year survival
was 44% in the IDC Group versus 5% in the IHD Group (long-rank,
P=0.004). Patients with IDC had a 77% relative risk reduction in death
from all causes compared to patients with IHD (odd ratio 0.27, 95%
confidence interval 0.13 to 0.70, P=0.007). In contrast, no underlying
disease-related difference in outcomes was observed in a retrospectively
analyzed historical comparison Group of 29 patients with end stage CHIF
treated by standard methods.
Conclusions: Patients with end stage CHF due to IDC derived a greater
survival benefit from IDI and oral amiodarone than patients with IHD.
(c) 2005 Elsevier Ireland Ltd. All rights reserved.
Συγγραφείς:
Tsagalou, EP
Anastasiou-Nana, MI
Terrovitis, JV
Nanas, SN
and Alexopoulos, GP
Kanakakis, J
Nanas, JN
Περιοδικό:
International Journal of Cardiology
Εκδότης:
Elsevier Ireland Ltd
Λέξεις-κλειδιά:
congestive heart failure; cardiomyopathy; ischemic heart disease;
inotropic agents; intermittent dobutamine
DOI:
10.1016/j.ijcard.2005.05.012
