Efficacy and Limitations of Oral Inotropic Agents for the Treatment of Chronic Heart Failure:A Single Center Cross-Sectional Observational Study
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概要
- 論文の詳細を見る
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 (<I>P</I> = 0.017), cardiothoracic ratio (<I>P</I> = 0.002) and B-type natriuretic peptide levels (<I>P</I> = 0.011) were significantly improved, and the number of emergency room (ER) visits (<I>P</I> < 0.001) and hospitalizations (<I>P</I> < 0.001) were significantly reduced. The nonsurviving patients (<I>n</I> = 7/31, 22.6%) were significantly older (<I>P</I> = 0.02) and tended to have a larger cardiothoracic ratio (<I>P</I> = 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, <I>P</I> = 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.
著者
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Maruyama Mitsunori
Department of 1st Internal Medicine, Nippon Medical School
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Inami Toru
Department of Cardiovascular center, Chiba-Hokusoh Hospital, Nippon Medical School
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Ohba Takayoshi
Department of Cardiovascular center, Chiba-Hokusoh Hospital, Nippon Medical School
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Takano Masamichi
Department of Internal Medicine, Chiba-Hokusoh Hospital, Nippon Medical School
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Murai Koji
Department Of Bioscience Fukui Prefectural University
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Kimata Nakahisa
Department Of Cardiology Shizuoka Medical Center
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Mizuno Kyoichi
Department Of 1st Internal Medicine Nippon Medical School
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Yodogawa Kenji
Department Of Cardiology Tohsei National Hospital
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Ibuki Chikao
Departent Of Cardiology Chiba-hokuso Hospital Nippon Medical School
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Abe Junko
Department Of Energy Conversion Science Graduate School Of Energy Science Kyoto University
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Seino Yoshihiko
Department Of Cardiology Chiba-hokuso Hospital
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Kimata Nakahisa
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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Ohba Takayoshi
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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Takano Masamichi
Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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Murai Koji
Department of Cardiology, Nippon Medical School
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Inami Toru
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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Seino Yoshihiko
Department of Cardiology, Cardiovascular Center, Nippon Medical School Chiba-Hokusoh Hospital
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