Document Detail


Symptoms, haemodynamics, and exercise capacity during long term treatment of chronic heart failure. Experience with pirbuterol.
MedLine Citation:
PMID:  6137226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An open study of long term treatment with an oral beta 2 agonist (pirbuterol 20 mg three times daily) was undertaken in 63 patients with severe chronic heart failure. During three months of treatment 20 (32%) patients died, of whom 16 were taking the drug at the time of death. Mortality was related to initial functional class (New York Heart Association classification: 23% in grade III and 75% in grade IV). Concomitant treatment with digoxin did not affect mortality. The drug was well tolerated by most patients but unwanted side effects necessitated withdrawal of the drug in six (10%). Thirty-five patients were continuing to take the drug after three months, of whom 22 reported symptomatic improvement and only four deterioration. There was a relation between symptomatic improvement and increase in exercise capacity. At initial haemodynamic assessment a single dose of pirbuterol increased the cardiac index by 34% and the stroke index by 21%. Left ventricular filling pressure fell by 23% and systemic vascular resistance by 22%. Haemodynamic reassessment after three months of continuous treatment in 29 patients showed maintained improvement in the group as a whole, although individual variation was considerable. There was no apparent relation between haemodynamic improvement and improvement in exercise duration and symptoms. Severe heart failure has a poor prognosis. Identification of those patients who may derive benefit from treatment with a particular drug is not yet possible.
Authors:
J R Dawson; R Canepa-Anson; P Kuan; S R Reuben; P A Poole-Wilson; G C Sutton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  50     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1983 Sep 
Date Detail:
Created Date:  1983-11-23     Completed Date:  1983-11-23     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  282-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / adverse effects,  therapeutic use*
Adult
Aged
Cardiotonic Agents / adverse effects,  therapeutic use*
Ethanolamines / adverse effects,  therapeutic use*
Female
Heart Failure / drug therapy*,  physiopathology
Hemodynamics / drug effects
Humans
Male
Middle Aged
Physical Exertion
Time Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Cardiotonic Agents; 0/Ethanolamines; 38677-81-5/pirbuterol
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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