Changes in the Occurrence of Mechanical Alternans After Long-Term β-Blocker Therapy in Patients With Chronic Heart Failure

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• Mechanical alternans has been observed in patients with severe congestive heart failure, and the phenomenon is considered to be a terminal sign. Therapeutic strategies for chronic heart failure have significantly developed, but it is uncertain whether patients with mechanical alternans can be effectively treated or not. Seventeen consecutive patients with dilated cardiomyopathy were enrolled: 11 were treated with β-blockers on conventional therapeutic regimens and 6 patients were not indicated for or were unable to continue β-blockade. Mechanical alternans was detected during cardiac catheterization in the patients under physiologic tachycardia (110 beats/min) and stepwise dobutamine loading. In the initial study, mechanical alternans occurred in 70.6% of the patients: 8 of the 11 being treated with β-blockers and 4 of the 6 without β-blockade therapy. In the second study, none of the patients taking β-blockers showed mechanical alternans under the same protocol; the occurrence of mechanical alternans did not change in the patients who were not being treated with β-blockers. The left ventricular ejection fraction increased in patients whose mechanical alternans could not be induced during the follow up, but decreased in the patients in whom mechanical alternans was repeatedly inducible. It is concluded that mechanical alternans is associated with the falling myocardium and may be potentially correctable.

• 社団法人日本循環器学会の論文
• 2001-07-20

著者

• Kato Kiminori

  Niigata Association of Occupational Health

• Aizawa Yoshifusa

  First Department of Internal Medicine, Niigata University School of Medicine

• Kodama Makoto

  First Department of Internal Medicine, Division of Cardiology, Niigata University School of Medicine

• Kato Kiminori

  First Department of Internal Medicine, Niigata University Hospital

• HIRONO Satoru

  First Department of Internal Medicine, Niigata University School of Medicine

• FUSE Koichi

  First Department of Internal Medicine, Niigata University School of Medicine

• Saikawa Takashi

  First Department Of Internal Medicine Division Of Cardiology Niigata University School Of Medicine

• Hayashi Manabu

  新潟大学 医歯学総合研究科循環器学

• Fuse Koichi

  Cardiovascular Center Tachikawa General Hospital

• Fuse Koichi

  新潟大学 医学部第一内科

• Abe Shori

  東北大学 感染制御･検査診断学分野

• Abe Shori

  Department Of Rheumatology And Hematology Tohoku University School Of Medicine

• Ohkura Yuji

  新潟大学 医歯学総合研究科循環器学分野

• Shiono Takaaki

  Niigata Rinko Hospital

• Tachikawa Hitoshi

  Department of Cardiology, Niigata University School of Medicine

• Abe Satoru

  Division Of Cardiology Niigata University Graduate School Of Medical And Dental Sciences

• Hirono Satoru

  First Department Of Medicine Niigata University School Of Medicine

• Sato Hironori

  1st Dept. Of Med. Niigata Univ. School Of Med.

• Hanawa H

  Division Of Cardiology Niigata University Graduate School Of Medical And Dental Sciences

• Hanawa Haruo

  First Dept of Internal Medicine

• ITO MASAHIRO

  First Department of Internal Medicine, Hiroshima University Medical Hospital

• TACHIKAWA Hitoshi

  First Department of Medicine, Niigata University School of Medicine

• Shiono Takaaki

  First Department of Internal Medicine, Niigata University School of Medicine

• Okura Yuji

  First Department of Internal Medicine, Niigata University School of Medicine

• Hayashi Manabu

  First Department of Internal Medicine, Niigata University School of Medicine

• Abe Satoru

  First Department of Internal Medicine, Niigata University School of Medicine

• Yoshida Tsuyoshi

  First Department of Internal Medicine, Niigata University School of Medicine

• Tachikawa Hitoshi

  Department Of Cardiology Niigata University School Of Medicine

• Hayashi Manabu

  Divisions Of Cardiology Niigata University Graduate School Of Medical And Dental Sciences

• Saigawa Takashi

  Division Of Cardiology Niigata University Graduate School Of Medical And Dental Sciences

• Hirono Satoru

  Division Of Cardiology Niigata University School Of Medical And Dental Sciences

• Abe Satoru

  Department Of Internal Medicine Osaki Citizen Hospital

• Aizawa Yoshifusa

  First Department Of Internal Medicine Niigata Universaity School Of Medicine

• Kodama Makoto

  First Dep. Of Medicine Graduate School Of Medical And Dental Sciences Niigata Univ.

• Ito Masahiro

  First Department Of Internal Medicine Niigata University School Of Medicine

• TACHIKAWA Hitoshi

  First Department of Internal Medicine, Radioisotope Center, Niigata University Graduate School of Medicine:Department of Clinical Pharmacology, Niigata College of Pharmacy

• Tachikawa Hitoshi

  First Department of Internal Medicine, Niigata University Graduate School of Medical and Dental Sciences

• HANAWA Haruo

  First Department of Internal Medicine, Niigata University Scoolof Medicine

• HANAWA Haruo

  First Department of Internal Medicine, Niigata University

• HIRONO Satoru

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

• KATO Kiminori

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

• FUSE Koichi

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

• AIZAWA Yoshifusa

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

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