Document Detail

Recognition and management of asymptomatic patients with left ventricular dysfunction.
MedLine Citation:
PMID:  1626486     Owner:  NLM     Status:  MEDLINE    
In recent years there have been encouraging developments in the therapy for congestive heart failure. Vasodilator therapy, as an adjunct to digitalis and diuretics, has made a major impact. Vasodilator therapy results in improved left ventricular (LV) ejection fraction, improved functional capacity, and enhanced quality of life. When an angiotensin-converting enzyme (ACE) inhibitor is used, several studies published since 1988 show that these improvements are accompanied by improved survival. Yet many questions remain. Principal among these is how to approach the patient who has significantly depressed LV function, but is asymptomatic or has only minimal symptoms. In these patients the prognosis cannot be based on New York Heart Association (NYHA) functional class, but must reflect objective measurements of ventricular function. Any intervention should be specifically designed to improve survival, since functional capacity and quality of life are apparently unimpaired. On the other hand, there are no data at present to suggest that intervention in these patients will improve survival. This article considers the evaluation of such asymptomatic patients and potential therapeutic approaches. These are the use of cardiac glycosides, the use of ACE inhibitors, or their combination. Circumstantial evidence supporting their use in this select patient population is considered. It is stressed that any decision to intervene therapeutically in the asymptomatic patient must be made by the physician on an individual basis.
D McCall
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  69     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-08-13     Completed Date:  1992-08-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  130G-139G; disc. 139G-140G     Citation Subset:  AIM; IM    
Department of Medicine/Division of Cardiology, University of Texas Health Science Center, San Antonio 78284-7872.
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MeSH Terms
Digitalis Glycosides / therapeutic use
Drug Therapy, Combination
Heart Failure / diagnosis,  drug therapy*,  physiopathology
Vasodilator Agents / therapeutic use
Ventricular Function, Left*
Reg. No./Substance:
0/Digitalis Glycosides; 0/Vasodilator Agents

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