| Amiodarone rescue therapy for severe decompensated heart failure initially unsuitable for beta-blockers. | |
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MedLine Citation:
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PMID: 14506543 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Beta-blocker therapy is now standard therapy for patients with stable heart failure; however, fluid-overloaded, New York Heart Association Class IV patients tolerate beta-blockers poorly. Amiodarone, a drug with antiadrenergic effects, has been shown to improve survival for patients with heart rates of 90 beats per minute or greater. METHODS: We reviewed 26 patients with severe decompensated heart failure who were started on oral amiodarone for heart rate control. beta-Blocker titration was attempted when patients became clinically stable. RESULTS: The mean age of the patients was 48.5 +/- 17.5 years, and 73% were male. Fifteen patients were New York Heart Association Class IV, and 11 were Class III. Of these, 23 (88%) were fluid-overloaded, and 11 (42%) were on inotropic agents when amiodarone was started. The mean ejection fraction was 16.1 +/- 6%. The initial dose of amiodarone was 346 +/- 120 mg/day. Twenty (77%) patients were successfully started on beta-blockers. At follow-up prior to beta-blockers, 20 (77%) patients improved by at least one New York Heart Association class. Heart rate decreased from a mean of 98 +/- 15 to 78 +/- 13 beats per minute (P <.0001). Echocardiograms were available in 12 patients, with ejection fractions increasing from 16.1 +/- 8% to 26.8 +/- 13% (P =.004). CONCLUSIONS: Amiodarone may be an effective rescue therapy for patients with decompensated heart failure and serve as a bridge to subsequent beta-blocker therapy. |
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Authors:
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Daniel C Choo; Bonnie Huiskes; Jennifer Jones; Sharon Fabbri; Lee Ann Hawkins; Kanu Chatterjee; Theresa De Marco; J Thomas Heywood |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of cardiovascular pharmacology and therapeutics Volume: 8 ISSN: 1074-2484 ISO Abbreviation: J. Cardiovasc. Pharmacol. Ther. Publication Date: 2003 Sep |
Date Detail:
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Created Date: 2003-09-24 Completed Date: 2003-12-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9602617 Medline TA: J Cardiovasc Pharmacol Ther Country: United States |
Other Details:
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Languages: eng Pagination: 187-92 Citation Subset: IM |
Affiliation:
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Division of Cardiology, International Heart Institute, Loma Linda University Medical Center, Loma Linda, California 92354, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use* Adult Aged Amiodarone / therapeutic use* Anti-Arrhythmia Agents / therapeutic use* Cohort Studies Echocardiography Heart Failure / drug therapy*, physiopathology Heart Rate Humans Male Middle Aged Stroke Volume |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone |
| Comments/Corrections | |
Comment In:
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J Cardiovasc Pharmacol Ther. 2003 Sep;8(3):175-8
[PMID:
14506541
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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