PMID- 1967337
OWN - NLM
STAT- MEDLINE
DCOM- 19900212
LR  - 20190610
IS  - 0140-6736 (Print)
IS  - 0140-6736 (Linking)
VI  - 335
IP  - 8680
DP  - 1990 Jan 6
TI  - Metolazone in treatment of severe refractory congestive cardiac failure.
PG  - 29-31
AB  - 17 patients with New York Heart Association (NYHA) class IV congestive cardiac 
      failure, refractory to conventional treatment, were additionally treated with 
      oral metolazone (1.25-10 mg daily). 12 improved sufficiently to be discharged 
      from hospital (NYHA class II or III, mean weight loss 8.3 kg), 1 of whom died at 
      home 4 weeks later. The other 5 patients were treated with intravenous dobutamine 
      for 72 h; 2 responded (average weight loss 4.4 kg), and 2 responded to subsequent 
      reintroduction of metolazone. 4 of these 5 patients died, 2 in hospital of acute 
      myocardial infarction. Overall, 15 patients with very severe refractory cardiac 
      failure improved sufficiently to be discharged from hospital. Treatment was 
      associated with mild transient hypokalaemia in 7 patients, and hyponatraemia and 
      renal impairment in 1, for whom metolazone dosage had to be reduced. Failure to 
      respond to the introduction of metolazone may indicate an especially poor 
      prognosis.
FAU - Kiyingi, A
AU  - Kiyingi A
AD  - Department of Cardiology, Concord Hospital, New South Wales, Australia.
FAU - Field, M J
AU  - Field MJ
FAU - Pawsey, C C
AU  - Pawsey CC
FAU - Yiannikas, J
AU  - Yiannikas J
FAU - Lawrence, J R
AU  - Lawrence JR
FAU - Arter, W J
AU  - Arter WJ
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - England
TA  - Lancet
JT  - Lancet (London, England)
JID - 2985213R
RN  - 0 (Diuretics)
RN  - 3S12J47372 (Dobutamine)
RN  - TZ7V40X7VX (Metolazone)
SB  - IM
CIN - Lancet. 1990 Apr 14;335(8694):922-3. PMID: 1970014
CIN - Lancet. 1990 Apr 28;335(8696):1031-2. PMID: 1970077
MH  - Aged
MH  - Aged, 80 and over
MH  - Body Weight/drug effects
MH  - Clinical Trials as Topic
MH  - Diuresis/drug effects
MH  - Diuretics/*therapeutic use
MH  - Dobutamine/administration & dosage/therapeutic use
MH  - Drug Evaluation
MH  - Drug Therapy, Combination
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Metolazone/administration & dosage/adverse effects/*therapeutic use
MH  - Middle Aged
MH  - Prognosis
EDAT- 1990/01/06 00:00
MHDA- 1990/01/06 00:01
CRDT- 1990/01/06 00:00
PHST- 1990/01/06 00:00 [pubmed]
PHST- 1990/01/06 00:01 [medline]
PHST- 1990/01/06 00:00 [entrez]
AID - 0140-6736(90)90148-X [pii]
AID - 10.1016/0140-6736(90)90148-x [doi]
PST - ppublish
SO  - Lancet. 1990 Jan 6;335(8680):29-31. doi: 10.1016/0140-6736(90)90148-x.