PMID- 2954776
OWN - NLM
STAT- MEDLINE
DCOM- 19870812
LR  - 20190514
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 92
IP  - 1
DP  - 1987 Jul
TI  - Survival in severe left ventricular failure treated with the new nonglycosidic, 
      nonsympathomimetic oral inotropic agents.
PG  - 118-23
AB  - Survival in severe left ventricular failure is poor but has not been widely 
      assessed since the introduction of several new nonglycosidic, nonsympathomimetic 
      oral inotropic agents for long-term therapy. We examined retrospectively the 
      survival of 82 patients with severe left heart failure during long-term treatment 
      with oral milrinone (17 patients), posicor (12 patients), enoximone (47 
      patients), and piroximone (6 patients). Sixty-five patients were in New York 
      Heart Association (NYHA) functional class 4, 15 patients were in class 3, and two 
      patients were in class 2. There were 57 patients with ischemic and 25 patients 
      were in class 2. There were 57 patients with ischemic and 25 patients with 
      nonischemic etiology of left heart failure. Most patients were referred for 
      inotropic therapy after failing to respond to conventional agents, including 
      vasodilators. However, in almost all patients, marked hemodynamic and clinical 
      improvement occurred initially. Overall survival was 36 percent at six months, 
      the majority of deaths occurring during the first three months. Survival in 
      relation to etiology of heart failure showed a trend toward increased mortality 
      in patients associated with ischemic heart disease vs non-ischemic dilated 
      cardiomyopathy. Sudden death mortality was also higher in the ischemic group (28 
      percent at six months vs 5 percent at six months; p less than 0.05). There was a 
      trend toward reduced sudden death mortality in patients on antiarrhythmic agents 
      during inotropic therapy (p = 0.06). We conclude that overall survival in 
      symptomatic patients with severe left ventricular failure remains very low during 
      long-term therapy with several new oral inotropic agents. Sudden death appears 
      higher in patients with an ischemic etiology during therapy with these agents.
FAU - Simonton, C A
AU  - Simonton CA
FAU - Daly, P A
AU  - Daly PA
FAU - Kereiakes, D
AU  - Kereiakes D
FAU - Modin, G
AU  - Modin G
FAU - Chatterjee, K
AU  - Chatterjee K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Imidazoles)
RN  - 0 (Pyridones)
RN  - 0 (Quinazolines)
RN  - 2VSD0380YB (piroximone)
RN  - C7Z4ITI7L7 (Enoximone)
RN  - D1Q7F6C2FP (quazinone)
RN  - JU9YAX04C7 (Milrinone)
SB  - IM
MH  - Administration, Oral
MH  - Aged
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - Cardiotonic Agents/*administration & dosage
MH  - Death, Sudden/epidemiology
MH  - Drug Evaluation
MH  - Enoximone
MH  - Female
MH  - Heart Failure/*drug therapy/mortality
MH  - Humans
MH  - Imidazoles/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Milrinone
MH  - Pyridones/*administration & dosage
MH  - Quinazolines/*administration & dosage
MH  - Retrospective Studies
MH  - Time Factors
EDAT- 1987/07/01 00:00
MHDA- 1987/07/01 00:01
CRDT- 1987/07/01 00:00
PHST- 1987/07/01 00:00 [pubmed]
PHST- 1987/07/01 00:01 [medline]
PHST- 1987/07/01 00:00 [entrez]
AID - S0012-3692(16)37650-4 [pii]
AID - 10.1378/chest.92.1.118 [doi]
PST - ppublish
SO  - Chest. 1987 Jul;92(1):118-23. doi: 10.1378/chest.92.1.118.