PMID- 9410772
OWN - NLM
STAT- MEDLINE
DCOM- 19971208
LR  - 20131121
IS  - 0046-5968 (Print)
IS  - 0046-5968 (Linking)
VI  - 27
IP  - 10
DP  - 1997 Oct
TI  - [Improvement of short-term prognosis in patients with refractory heart failure].
PG  - 1024-8
AB  - BACKGROUND: Prognosis of patients with severe heart failure is poor, despite 
      improved results in medical therapy. Heart transplantation is the only treatment 
      possible in end-stage heart failure. The aim of this study was to evaluate the 
      variation in prognosis over the past six years in the patients admitted to 
      Intensive Care Unit for heart failure in spite of optimal oral therapy. STUDY 
      POPULATION AND METHOD: Between January 1990 and December 1995, 133 patients with 
      heart failure were admitted to the Intensive Care Unit, despite the fact that 
      they were on optimal oral therapy. All patients were in New York Heart 
      Association (NYHA) functional class III to IV and required intravenous 
      administration of sympathomimetic amines, in addition to standard heart failure 
      treatment procedures. Cumulative survival at six months of patients observed 
      between 1990-1992 (group A) was compared with the survival rate of patients 
      observed from 1993 to 1995 (group B). RESULTS: Clinical and haemodynamic 
      parameters were similar in groups A and B, but ACE-inhibitors were used more 
      frequently in group B (75 vs 31% respectively, p < 0.05). During the follow-up 
      period, heart transplantation was indicated in a similar percentage of patients 
      (A 53% vs B 58%). However, mortality on the waiting list (58% group A vs 21% 
      group B; p < 0.05) and the percentage of patients who underwent heart 
      transplantation (41% group A vs 78% group B; p < 0.05) differed. Moreover, all 
      patients in group A and 50% of group B were operated on as "status one" patients. 
      The total six-month mortality rate decreased from 69% before 1992 to 48% 
      thereafter (p < 0.05). CONCLUSION: The short-term prognosis of patients with 
      refractory heart failure improved over time. In the latter period, ACE-inhibitors 
      were used more frequently and the number of heart transplantations was greater. 
      Nevertheless, our results do not allow us to identify the causes of the improved 
      survival rate.
FAU - Boffa, G M
AU  - Boffa GM
AD  - Cattedra di Cardiologia, Universita degli Studi di Padova.
FAU - Cannas, S
AU  - Cannas S
FAU - Cacciavillani, L
AU  - Cacciavillani L
FAU - Marzari, A
AU  - Marzari A
FAU - Grassi, G
AU  - Grassi G
FAU - Bauce, B
AU  - Bauce B
FAU - Livi, U
AU  - Livi U
FAU - Maddalena, F
AU  - Maddalena F
LA  - ita
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
TT  - Miglioramento della prognosi a breve termine dei pazienti con scompenso cardiaco 
      refrattario.
PL  - Italy
TA  - G Ital Cardiol
JT  - Giornale italiano di cardiologia
JID - 1270331
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Sympathomimetics)
RN  - 3S12J47372 (Dobutamine)
RN  - VTD58H1Z2X (Dopamine)
RN  - X4W3ENH1CV (Norepinephrine)
RN  - YKH834O4BH (Epinephrine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Assisted Circulation
MH  - Cardiotonic Agents/therapeutic use
MH  - Coronary Care Units
MH  - Data Interpretation, Statistical
MH  - Dobutamine/therapeutic use
MH  - Dopamine/therapeutic use
MH  - Epinephrine/therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/drug therapy/*mortality/physiopathology
MH  - Heart Transplantation
MH  - Hemodynamics
MH  - Hemofiltration
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Norepinephrine/therapeutic use
MH  - Prognosis
MH  - Survival Rate
MH  - Sympathomimetics/therapeutic use
MH  - Time Factors
MH  - Ventilators, Mechanical
EDAT- 1997/12/31 00:00
MHDA- 1997/12/31 00:01
CRDT- 1997/12/31 00:00
PHST- 1997/12/31 00:00 [pubmed]
PHST- 1997/12/31 00:01 [medline]
PHST- 1997/12/31 00:00 [entrez]
PST - ppublish
SO  - G Ital Cardiol. 1997 Oct;27(10):1024-8.