Background: The aim of this study was to evaluate the longterm effect of combined intermittent dobutamine infusions(IDI) and oral amiodarone on reverse left ventricular(LV) remodeling and hemodynamics of patients with...Background: The aim of this study was to evaluate the longterm effect of combined intermittent dobutamine infusions(IDI) and oral amiodarone on reverse left ventricular(LV) remodeling and hemodynamics of patients with idiopathic dilated cardiomyopathy(IDC) and end-stage congestive heart failure(CHF). Methods: This non-randomized, prospective, clinical trial included sixteen consecutive patients suffering from dyspnea for a mean of 76± 43 months, who presented with acute cardiac decompensation and were weaned from dobutamine therapy after an initial 72-h infusion. They were then placed on a regimen of oral amiodarone, 400 mg/day and weekly IDI, 10 μ g/kg/min, for 8 h. The long-term clinical outcomes and the effects of treatment on reverse LV remodeling(echocardiographic parameters) and hemodynamics were evaluated at 3, 6, and 12 months of follow up. Results: A significant degree of reverse LV remodeling, hemodynamic improvements, and survivals >1.5 years were observed in 9 of the 16 patients(56% ). In addition, 5 patients(31% of entire cohort) were weaned from IDI after a mean of 61± 41 weeks, and 4 remained clinically stable for 116± 66 weeks thereafter. At 12 months of follow-up, LV end-diastolic and end-systolic volume indices had decreased from 231± 91 to 206± 80 ml/m2(P=0.002) and from 137± 65 to 110± 50 ml/m2(P=0.003), respectively, right atrial pressure from 16± 6 to 5.6± 4 mm Hg,(P=0.031), and pulmonary capillary wedge pressure from 29± 4 to 16± 5.4 mm Hg, P=0.000, while LV ejection fraction had increased from 22± 6% to 27.3± 8% (P=0.006). Conclusions: In end-stage CHF due to IDC, long-term treatment with IDI and oral amiodarone caused reverse LV remodeling, and allowed permanent and successful weaning from IDI in 1 / 4 of patients.展开更多
目的:观察黄芪注射液治疗缺血性心肌病终末期心衰的短期疗效。方法:选取本院2012年6月—2014年3月间收治的缺血性心肌病所致的终末期心衰患者共106例,将其随机分为治疗组和对照组,每组各53例,两组患者均接受规范的冠心病二级预防措施和...目的:观察黄芪注射液治疗缺血性心肌病终末期心衰的短期疗效。方法:选取本院2012年6月—2014年3月间收治的缺血性心肌病所致的终末期心衰患者共106例,将其随机分为治疗组和对照组,每组各53例,两组患者均接受规范的冠心病二级预防措施和心力衰竭标准化治疗,治疗组在上述治疗的基础上加用黄芪注射液20 m L+5%葡萄糖注射液250 m L,1次/d,静点,14天为1个疗程。两组患者治疗前后分别通过NYHA心功能分级、6 min步行试验、B型钠尿肽、左室射血分数(LVEF)评估患者心衰程度,同时在治疗前及治疗结束时查血、尿常规,电解质,肝、肾功能、心电图。结果:两组患者治疗前上述指标无统计学意义(P>0.05)。治疗后两组患者心衰程度差异有统计学意义(P<0.05),治疗组NYHA分级、6 min步行试验、B型钠尿肽、左室射血分数(LVEF)均有明显改善,与对照组比较均有统计学意义(P<0.05)。治疗前后患者血、尿常规,电解质、肝肾功能、凝血系列无明显异常。结论:黄芪注射液可以安全有效的改善缺血性心肌病终末期心衰程度。展开更多
文摘Background: The aim of this study was to evaluate the longterm effect of combined intermittent dobutamine infusions(IDI) and oral amiodarone on reverse left ventricular(LV) remodeling and hemodynamics of patients with idiopathic dilated cardiomyopathy(IDC) and end-stage congestive heart failure(CHF). Methods: This non-randomized, prospective, clinical trial included sixteen consecutive patients suffering from dyspnea for a mean of 76± 43 months, who presented with acute cardiac decompensation and were weaned from dobutamine therapy after an initial 72-h infusion. They were then placed on a regimen of oral amiodarone, 400 mg/day and weekly IDI, 10 μ g/kg/min, for 8 h. The long-term clinical outcomes and the effects of treatment on reverse LV remodeling(echocardiographic parameters) and hemodynamics were evaluated at 3, 6, and 12 months of follow up. Results: A significant degree of reverse LV remodeling, hemodynamic improvements, and survivals >1.5 years were observed in 9 of the 16 patients(56% ). In addition, 5 patients(31% of entire cohort) were weaned from IDI after a mean of 61± 41 weeks, and 4 remained clinically stable for 116± 66 weeks thereafter. At 12 months of follow-up, LV end-diastolic and end-systolic volume indices had decreased from 231± 91 to 206± 80 ml/m2(P=0.002) and from 137± 65 to 110± 50 ml/m2(P=0.003), respectively, right atrial pressure from 16± 6 to 5.6± 4 mm Hg,(P=0.031), and pulmonary capillary wedge pressure from 29± 4 to 16± 5.4 mm Hg, P=0.000, while LV ejection fraction had increased from 22± 6% to 27.3± 8% (P=0.006). Conclusions: In end-stage CHF due to IDC, long-term treatment with IDI and oral amiodarone caused reverse LV remodeling, and allowed permanent and successful weaning from IDI in 1 / 4 of patients.
文摘目的:观察黄芪注射液治疗缺血性心肌病终末期心衰的短期疗效。方法:选取本院2012年6月—2014年3月间收治的缺血性心肌病所致的终末期心衰患者共106例,将其随机分为治疗组和对照组,每组各53例,两组患者均接受规范的冠心病二级预防措施和心力衰竭标准化治疗,治疗组在上述治疗的基础上加用黄芪注射液20 m L+5%葡萄糖注射液250 m L,1次/d,静点,14天为1个疗程。两组患者治疗前后分别通过NYHA心功能分级、6 min步行试验、B型钠尿肽、左室射血分数(LVEF)评估患者心衰程度,同时在治疗前及治疗结束时查血、尿常规,电解质,肝、肾功能、心电图。结果:两组患者治疗前上述指标无统计学意义(P>0.05)。治疗后两组患者心衰程度差异有统计学意义(P<0.05),治疗组NYHA分级、6 min步行试验、B型钠尿肽、左室射血分数(LVEF)均有明显改善,与对照组比较均有统计学意义(P<0.05)。治疗前后患者血、尿常规,电解质、肝肾功能、凝血系列无明显异常。结论:黄芪注射液可以安全有效的改善缺血性心肌病终末期心衰程度。
