Efficacy and Limitations of Oral Inotropic Agents for the Treatment of Chronic Heart Failure
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- Murai Koji
- Department of Cardiology, Nippon Medical School
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- Seino Yoshihiko
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Kimata Nakahisa
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Inami Toru
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Murakami Daisuke
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Abe Junko
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Yodogawa Kenji
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Maruyama Mitsunori
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Takano Masamichi
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Ohba Takayoshi
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Ibuki Chikao
- Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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- Mizuno Kyoichi
- Department of Cardiology, Nippon Medical School
書誌事項
- タイトル別名
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- A Single Center Cross-Sectional Observational Study
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抄録
The heart failure guideline in Japan has stated the necessity of investigating the role of oral inotropic agents in patients with chronic heart failure (CHF), which are clinically available only in Japan. A total of 1,846 consecutive patients with heart failure (mean: 69.5 years old, 1,279 males) treated at our institute from November 2009 to August 2010 were investigated retrospectively. Thirty-one patients (1.84%) who had taken oral inotropic agents (pimobendan 27, docarpamine 6, and denopamine 4) were extracted for this study, and the efficacy and limitations of the treatments were analyzed. Following the oral inotropic treatment, the NYHA functional class (P = 0.017), cardiothoracic ratio (P = 0.002) and B-type natriuretic peptide levels (P = 0.011) were significantly improved, and the number of emergency room (ER) visits (P < 0.001) and hospitalizations (P < 0.001) were significantly reduced. The nonsurviving patients (n = 7/31, 22.6%) were significantly older (P = 0.02) and tended to have a larger cardiothoracic ratio (P = 0.084) compared with the survivors. An absence of concomitant beta-blocker therapy was significantly associated with a worse prognosis (oneyear mortality 2/21 versus 5/10, log rank, P = 0.011). Oral inotropic agents brought about improvements in the clinical parameters of CHF and a reduction in ER visits and hospitalizations. However, concomitant beta-blocker therapy should be considered for patients receiving oral inotropic treatment.
収録刊行物
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- International Heart Journal
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International Heart Journal 54 (2), 75-81, 2013
一般社団法人 インターナショナル・ハート・ジャーナル刊行会