PMID- 35243658
OWN - NLM
STAT- MEDLINE
DCOM- 20220428
LR  - 20230228
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 45
IP  - 5
DP  - 2022 May
TI  - Repetitive milrinone therapy in ambulatory advanced heart failure patients.
PG  - 488-494
LID - 10.1002/clc.23802 [doi]
AB  - BACKGROUND: Advanced heart failure (HF) patients usually poorly tolerate 
      guideline-directed HF medical therapy (GDMT) and suffer high rates of morbidity 
      and mortality. The use of continuous inotropes in the outpatient settings is 
      hampered by previous data showing excess morbidity. We aimed to assess the safety 
      and efficacy of repetitive, intermittent, short-term intravenous milrinone 
      therapy in advanced HF patients with an intention to introduce and up-titrate 
      GDMT and improve functional class. HYPOTHESIS: Repetitive, intermittent milrinone 
      therapy may assist with the stabilization of advanced HF patients. METHODS: 
      Advanced HF patients treated with beta-blockers and implanted with defibrillators 
      were initiated with repetitive, intermittent short-term intravenous milrinone 
      therapy at our HF outpatient unit. Patients were prospectively followed with 
      defibrillator interrogation, functional class assessment, B-natriuretic peptide 
      (BNP) levels, and echocardiography parameters. RESULTS: The cohort included 24 
      patients with a mean 330 +/- 240 days of milrinone therapy exposure. Mean age was 
      73 +/- 6 years with male predominance (96%). Following milrinone therapy, median 
      BNP levels decreased significantly (882 [286-3768] to 631 [278-1378] pg/ml, 
      p = .017) with a significant reduction in the number of patients with New York 
      Heart Association (NYHA) Class III and IV (p = .012, 0.013) and an increase in 
      number of patients on GDMT. Importantly, the number of total sustained 
      ventricular tachycardia events and HF hospitalizations did not change. 
      CONCLUSIONS: In this small cohort of advanced HF, repetitive, intermittent, 
      short-term milrinone therapy was found to be safe and potentially efficacious.
CI  - (c) 2022 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
FAU - Laufer-Perl, Michal
AU  - Laufer-Perl M
AUID- ORCID: 0000-0001-9105-2559
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Sadon, Sapir
AU  - Sadon S
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Zahler, David
AU  - Zahler D
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Milwidsky, Assi
AU  - Milwidsky A
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Sadeh, Ben
AU  - Sadeh B
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Sapir, Orly
AU  - Sapir O
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Granot, Yoav
AU  - Granot Y
AUID- ORCID: 0000-0002-3863-4493
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Korotetski, Liuba
AU  - Korotetski L
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Ketchker, Liora
AU  - Ketchker L
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Rosh, Maayan
AU  - Rosh M
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Banai, Shmuel
AU  - Banai S
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
FAU - Havakuk, Ofer
AU  - Havakuk O
AUID- ORCID: 0000-0002-5097-2698
AD  - Cardiology Division, Tel Aviv Sourasky Medical Center, affiliated to Tel Aviv 
      University, Tel Aviv, Israel.
LA  - eng
PT  - Journal Article
DEP - 20220304
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Cardiotonic Agents)
RN  - JU9YAX04C7 (Milrinone)
SB  - IM
CIN - Clin Cardiol. 2023 Feb;46(2):234. PMID: 36403272
MH  - Adrenergic beta-Antagonists
MH  - Aged
MH  - Cardiotonic Agents/adverse effects
MH  - Echocardiography
MH  - Female
MH  - *Heart Failure/diagnosis/drug therapy
MH  - Humans
MH  - Male
MH  - Milrinone
MH  - *Tachycardia, Ventricular
PMC - PMC9045071
OTO - NOTNLM
OT  - advanced heart failure
OT  - inotropes
OT  - milrinone
COIS- The authors declare no conflict of interests.
EDAT- 2022/03/05 06:00
MHDA- 2022/04/29 06:00
PMCR- 2022/03/04
CRDT- 2022/03/04 05:46
PHST- 2022/02/13 00:00 [revised]
PHST- 2021/10/22 00:00 [received]
PHST- 2022/02/15 00:00 [accepted]
PHST- 2022/03/05 06:00 [pubmed]
PHST- 2022/04/29 06:00 [medline]
PHST- 2022/03/04 05:46 [entrez]
PHST- 2022/03/04 00:00 [pmc-release]
AID - CLC23802 [pii]
AID - 10.1002/clc.23802 [doi]
PST - ppublish
SO  - Clin Cardiol. 2022 May;45(5):488-494. doi: 10.1002/clc.23802. Epub 2022 Mar 4.