PMID- 1626486
OWN - NLM
STAT- MEDLINE
DCOM- 19920813
LR  - 20190622
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 69
IP  - 18
DP  - 1992 Jun 4
TI  - Recognition and management of asymptomatic patients with left ventricular 
      dysfunction.
PG  - 130G-139G; disc. 139G-140G
AB  - 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.
FAU - McCall, D
AU  - McCall D
AD  - Department of Medicine/Division of Cardiology, University of Texas Health Science 
      Center, San Antonio 78284-7872.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Digitalis Glycosides)
RN  - 0 (Vasodilator Agents)
SB  - IM
MH  - Digitalis Glycosides/therapeutic use
MH  - Drug Therapy, Combination
MH  - Heart Failure/diagnosis/*drug therapy/physiopathology
MH  - Humans
MH  - Vasodilator Agents/therapeutic use
MH  - *Ventricular Function, Left
RF  - 45
EDAT- 1992/06/04 00:00
MHDA- 1992/06/04 00:01
CRDT- 1992/06/04 00:00
PHST- 1992/06/04 00:00 [pubmed]
PHST- 1992/06/04 00:01 [medline]
PHST- 1992/06/04 00:00 [entrez]
AID - 0002-9149(92)91261-2 [pii]
AID - 10.1016/0002-9149(92)91261-2 [doi]
PST - ppublish
SO  - Am J Cardiol. 1992 Jun 4;69(18):130G-139G; disc. 139G-140G. doi: 
      10.1016/0002-9149(92)91261-2.