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Titolo:
Changes in the occurrence of mechanical alternans after long-term beta-blocker therapy in patients with chronic heart failure
Autore:
Kodama, M; Kato, K; Hirono, S; Hanawa, H; Okura, Y; Ito, M; Fuse, K; Shiono, T; Tachikawa, H; Hayashi, M; Abe, S; Yoshida, T; Aizawa, Y;
Indirizzi:
Niigata Univ, Sch Med, Dept Internal Med 1, Niigata, Japan Niigata Univ Niigata Japan Sch Med, Dept Internal Med 1, Niigata, Japan
Titolo Testata:
JAPANESE CIRCULATION JOURNAL-ENGLISH EDITION
fascicolo: 8, volume: 65, anno: 2001,
pagine: 711 - 716
SICI:
0047-1828(200108)65:8<711:CITOOM>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
IDIOPATHIC DILATED CARDIOMYOPATHY; STIMULATION; CARVEDILOL; METOPROLOL; SURVIVAL; CALCIUM; MUSCLE;
Keywords:
beta-blockers; chronic heart failure; failing myocardium; mechanical alternans;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Kodama, M Niigata Univ, Sch Med, Dept Internal Med 1, Asahimachi 1-757, Niigata, Japan Niigata Univ Asahimachi 1-757 Niigata Japan 57, Niigata, Japan
Citazione:
M. Kodama et al., "Changes in the occurrence of mechanical alternans after long-term beta-blocker therapy in patients with chronic heart failure", JPN CIRC J, 65(8), 2001, pp. 711-716

Abstract

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 beta -blockers on conventional therapeutic regimens and 6 patients were not indicated for or were unable tocontinue beta -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 beta -blockers and 4 of the 6 without beta -blockade therapy, In the second study, none of the patients taking beta -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 beta -blockers. The leftventricular 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 failing myocardium and maybe potentially correctable.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 10:49:25