Prognostic Value of Hemodynamic vs Big Endothelin Measurements During Long-term IV Therapy in Advanced Heart Failure Patients
To compare hemodynamics and plasma big endothelin levels in patients awaiting heart transplantation who are receiving continuous IV therapy, and to establish their respective potency for predicting future cardiac events. A randomized, prospective trial of ambulatory continuous treatment with IV pros...
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| Veröffentlicht in: | Chest 2000-06, Vol.117 (6), p.1713-1719 |
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| creator | Frey, Bernhard Pacher, Richard Locker, Gottfried Bojic, Anda Hartter, Engelbert Woloszczuk, Wolfgang Stanek, Brigitte |
| description | To compare hemodynamics and plasma big endothelin levels in patients awaiting heart transplantation who are receiving continuous IV therapy, and to establish their respective potency for predicting future cardiac events.
A randomized, prospective trial of ambulatory continuous treatment with IV prostaglandin E1 (PGE1) vs dobutamine. A subanalysis was conducted of all patients who completed 4 weeks of follow-up in regard to treatment effects on hemodynamics and big endothelin plasma levels.
Thirty-two listed heart transplant candidates who were refractory to oral treatment, 21 patients who were receiving PGE1, and 11 patients receiving dobutamine.
Hemodynamics and plasma big endothelin levels were measured at baseline and after 4 weeks. The cardiac index increased significantly (PGE1 group, 1.7 ± 0.4 vs 2.5 ± 0.6 L/min/m2; dobutamine group, 1.8 ± 0.3 vs 2.3 ± 0.6 L/min/m2; p < 0.05), whereas the systemic vascular resistance index (SVRI) decreased significantly only in the PGE1 group (3,352 ± 954 vs 2,178 ± 519 dyne · s · cm−5/m2; p < 0.05). The plasma big endothelin level decreased significantly (PGE1 group, 7.6 ± 3.1 vs 4.7 ± 2.6 fmol/mL; dobutamine group, 6.5 ± 3.7 vs 5.0 ± 2.6 fmol/mL; p < 0.01 for the time effect). Plasma big endothelin (β = 0.393;χ 2 = 10.8; p = 0.001) and SVRI (β = 0.003;χ 2 = 6.9; p < 0.01), both measured after 4 weeks of continuous treatment, were the only independent predictors of future outcome.
Continuous treatment over 4 weeks with either PGE1 or dobutamine in patients awaiting heart transplantation yields an improved hemodynamic state accompanied by a reduction of increased big endothelin levels. Plasma big endothelin measured after 4 weeks of continuous therapy provides prognostic information about future outcome. |
| doi_str_mv | 10.1378/chest.117.6.1713 |
| format | Article |
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A randomized, prospective trial of ambulatory continuous treatment with IV prostaglandin E1 (PGE1) vs dobutamine. A subanalysis was conducted of all patients who completed 4 weeks of follow-up in regard to treatment effects on hemodynamics and big endothelin plasma levels.
Thirty-two listed heart transplant candidates who were refractory to oral treatment, 21 patients who were receiving PGE1, and 11 patients receiving dobutamine.
Hemodynamics and plasma big endothelin levels were measured at baseline and after 4 weeks. The cardiac index increased significantly (PGE1 group, 1.7 ± 0.4 vs 2.5 ± 0.6 L/min/m2; dobutamine group, 1.8 ± 0.3 vs 2.3 ± 0.6 L/min/m2; p < 0.05), whereas the systemic vascular resistance index (SVRI) decreased significantly only in the PGE1 group (3,352 ± 954 vs 2,178 ± 519 dyne · s · cm−5/m2; p < 0.05). The plasma big endothelin level decreased significantly (PGE1 group, 7.6 ± 3.1 vs 4.7 ± 2.6 fmol/mL; dobutamine group, 6.5 ± 3.7 vs 5.0 ± 2.6 fmol/mL; p < 0.01 for the time effect). Plasma big endothelin (β = 0.393;χ 2 = 10.8; p = 0.001) and SVRI (β = 0.003;χ 2 = 6.9; p < 0.01), both measured after 4 weeks of continuous treatment, were the only independent predictors of future outcome.
Continuous treatment over 4 weeks with either PGE1 or dobutamine in patients awaiting heart transplantation yields an improved hemodynamic state accompanied by a reduction of increased big endothelin levels. Plasma big endothelin measured after 4 weeks of continuous therapy provides prognostic information about future outcome.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.117.6.1713</identifier><identifier>PMID: 10858407</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: Elsevier Inc</publisher><subject>Adult ; Aged ; Alprostadil - administration & dosage ; Alprostadil - adverse effects ; Ambulatory Care ; big endothelin ; Biological and medical sciences ; Cardiotonic Agents - administration & dosage ; Cardiotonic Agents - adverse effects ; Cardiovascular system ; dobutamine ; Dobutamine - administration & dosage ; Dobutamine - adverse effects ; Endothelin-1 ; Endothelins - blood ; Female ; heart failure ; Heart Failure - drug therapy ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart Transplantation ; Hemodynamics - drug effects ; Humans ; Infusions, Intravenous ; Long-Term Care ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Pharmacology. Drug treatments ; Prognosis ; Prospective Studies ; prostaglandin E1 ; Protein Precursors - blood ; Survival Rate ; Vascular Resistance - drug effects ; Vasodilator Agents - administration & dosage ; Vasodilator Agents - adverse effects</subject><ispartof>Chest, 2000-06, Vol.117 (6), p.1713-1719</ispartof><rights>2000 The American College of Chest Physicians</rights><rights>2000 INIST-CNRS</rights><rights>Copyright American College of Chest Physicians Jun 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-7829d7c63c1895d45fbee797682f20158e28d5ff5cf495910c18f9f6383305c13</citedby><cites>FETCH-LOGICAL-c443t-7829d7c63c1895d45fbee797682f20158e28d5ff5cf495910c18f9f6383305c13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1392337$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10858407$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Frey, Bernhard</creatorcontrib><creatorcontrib>Pacher, Richard</creatorcontrib><creatorcontrib>Locker, Gottfried</creatorcontrib><creatorcontrib>Bojic, Anda</creatorcontrib><creatorcontrib>Hartter, Engelbert</creatorcontrib><creatorcontrib>Woloszczuk, Wolfgang</creatorcontrib><creatorcontrib>Stanek, Brigitte</creatorcontrib><title>Prognostic Value of Hemodynamic vs Big Endothelin Measurements During Long-term IV Therapy in Advanced Heart Failure Patients</title><title>Chest</title><addtitle>Chest</addtitle><description>To compare hemodynamics and plasma big endothelin levels in patients awaiting heart transplantation who are receiving continuous IV therapy, and to establish their respective potency for predicting future cardiac events.
A randomized, prospective trial of ambulatory continuous treatment with IV prostaglandin E1 (PGE1) vs dobutamine. A subanalysis was conducted of all patients who completed 4 weeks of follow-up in regard to treatment effects on hemodynamics and big endothelin plasma levels.
Thirty-two listed heart transplant candidates who were refractory to oral treatment, 21 patients who were receiving PGE1, and 11 patients receiving dobutamine.
Hemodynamics and plasma big endothelin levels were measured at baseline and after 4 weeks. The cardiac index increased significantly (PGE1 group, 1.7 ± 0.4 vs 2.5 ± 0.6 L/min/m2; dobutamine group, 1.8 ± 0.3 vs 2.3 ± 0.6 L/min/m2; p < 0.05), whereas the systemic vascular resistance index (SVRI) decreased significantly only in the PGE1 group (3,352 ± 954 vs 2,178 ± 519 dyne · s · cm−5/m2; p < 0.05). The plasma big endothelin level decreased significantly (PGE1 group, 7.6 ± 3.1 vs 4.7 ± 2.6 fmol/mL; dobutamine group, 6.5 ± 3.7 vs 5.0 ± 2.6 fmol/mL; p < 0.01 for the time effect). Plasma big endothelin (β = 0.393;χ 2 = 10.8; p = 0.001) and SVRI (β = 0.003;χ 2 = 6.9; p < 0.01), both measured after 4 weeks of continuous treatment, were the only independent predictors of future outcome.
Continuous treatment over 4 weeks with either PGE1 or dobutamine in patients awaiting heart transplantation yields an improved hemodynamic state accompanied by a reduction of increased big endothelin levels. Plasma big endothelin measured after 4 weeks of continuous therapy provides prognostic information about future outcome.</description><subject>Adult</subject><subject>Aged</subject><subject>Alprostadil - administration & dosage</subject><subject>Alprostadil - adverse effects</subject><subject>Ambulatory Care</subject><subject>big endothelin</subject><subject>Biological and medical sciences</subject><subject>Cardiotonic Agents - administration & dosage</subject><subject>Cardiotonic Agents - adverse effects</subject><subject>Cardiovascular system</subject><subject>dobutamine</subject><subject>Dobutamine - administration & dosage</subject><subject>Dobutamine - adverse effects</subject><subject>Endothelin-1</subject><subject>Endothelins - blood</subject><subject>Female</subject><subject>heart failure</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Transplantation</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Long-Term Care</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Pharmacology. Drug treatments</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>prostaglandin E1</subject><subject>Protein Precursors - blood</subject><subject>Survival Rate</subject><subject>Vascular Resistance - drug effects</subject><subject>Vasodilator Agents - administration & dosage</subject><subject>Vasodilator Agents - adverse effects</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kLFv1DAchS0EokdhZ0IWYs1hx3Ecs7WlpZUO0aF0tVz758RVEh92cugG_nd85CTKwGTZ-t571ofQW0rWlInmo-kgTWtKxbpeU0HZM7SiktGC8Yo9RytCaFmwWpYn6FVKjyTfqaxfohNKGt5URKzQr9sY2jGkyRt8r_sZcHD4GoZg96Me8uMu4XPf4svRhqmD3o_4K-g0RxhgnBL-PEc_tngTxraYIA745h7fdRD1do8ze2Z3ejRgc6WOE77Svs9RfKsnf4i_Ri-c7hO8OZ6n6PvV5d3FdbH59uXm4mxTmKpiUyGaUlphamZoI7mtuHsAEFLUTelKQnkDZWO5c9y4SnJJSeacdDVrGCPcUHaK3i-92xh-zNmZegxzHPOkKgnhJeWVyBBZIBNDShGc2kY_6LhXlKiDbvVHt8q6Va0OunPk3bF3fhjAPgksfjPw4QjoZHTvYrbh01-OyZKxJ9Odb7ufPoJKg-773MqW0eN3_5n-tEQge9t5iCqZ7DS7znEzKRv8___9G9cOrc4</recordid><startdate>20000601</startdate><enddate>20000601</enddate><creator>Frey, Bernhard</creator><creator>Pacher, Richard</creator><creator>Locker, Gottfried</creator><creator>Bojic, Anda</creator><creator>Hartter, Engelbert</creator><creator>Woloszczuk, Wolfgang</creator><creator>Stanek, Brigitte</creator><general>Elsevier Inc</general><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20000601</creationdate><title>Prognostic Value of Hemodynamic vs Big Endothelin Measurements During Long-term IV Therapy in Advanced Heart Failure Patients</title><author>Frey, Bernhard ; Pacher, Richard ; Locker, Gottfried ; Bojic, Anda ; Hartter, Engelbert ; Woloszczuk, Wolfgang ; Stanek, Brigitte</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-7829d7c63c1895d45fbee797682f20158e28d5ff5cf495910c18f9f6383305c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alprostadil - administration & dosage</topic><topic>Alprostadil - adverse effects</topic><topic>Ambulatory Care</topic><topic>big endothelin</topic><topic>Biological and medical sciences</topic><topic>Cardiotonic Agents - administration & dosage</topic><topic>Cardiotonic Agents - adverse effects</topic><topic>Cardiovascular system</topic><topic>dobutamine</topic><topic>Dobutamine - administration & dosage</topic><topic>Dobutamine - adverse effects</topic><topic>Endothelin-1</topic><topic>Endothelins - blood</topic><topic>Female</topic><topic>heart failure</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Transplantation</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Long-Term Care</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Pharmacology. Drug treatments</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>prostaglandin E1</topic><topic>Protein Precursors - blood</topic><topic>Survival Rate</topic><topic>Vascular Resistance - drug effects</topic><topic>Vasodilator Agents - administration & dosage</topic><topic>Vasodilator Agents - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Frey, Bernhard</creatorcontrib><creatorcontrib>Pacher, Richard</creatorcontrib><creatorcontrib>Locker, Gottfried</creatorcontrib><creatorcontrib>Bojic, Anda</creatorcontrib><creatorcontrib>Hartter, Engelbert</creatorcontrib><creatorcontrib>Woloszczuk, Wolfgang</creatorcontrib><creatorcontrib>Stanek, Brigitte</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Frey, Bernhard</au><au>Pacher, Richard</au><au>Locker, Gottfried</au><au>Bojic, Anda</au><au>Hartter, Engelbert</au><au>Woloszczuk, Wolfgang</au><au>Stanek, Brigitte</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Value of Hemodynamic vs Big Endothelin Measurements During Long-term IV Therapy in Advanced Heart Failure Patients</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2000-06-01</date><risdate>2000</risdate><volume>117</volume><issue>6</issue><spage>1713</spage><epage>1719</epage><pages>1713-1719</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>To compare hemodynamics and plasma big endothelin levels in patients awaiting heart transplantation who are receiving continuous IV therapy, and to establish their respective potency for predicting future cardiac events.
A randomized, prospective trial of ambulatory continuous treatment with IV prostaglandin E1 (PGE1) vs dobutamine. A subanalysis was conducted of all patients who completed 4 weeks of follow-up in regard to treatment effects on hemodynamics and big endothelin plasma levels.
Thirty-two listed heart transplant candidates who were refractory to oral treatment, 21 patients who were receiving PGE1, and 11 patients receiving dobutamine.
Hemodynamics and plasma big endothelin levels were measured at baseline and after 4 weeks. The cardiac index increased significantly (PGE1 group, 1.7 ± 0.4 vs 2.5 ± 0.6 L/min/m2; dobutamine group, 1.8 ± 0.3 vs 2.3 ± 0.6 L/min/m2; p < 0.05), whereas the systemic vascular resistance index (SVRI) decreased significantly only in the PGE1 group (3,352 ± 954 vs 2,178 ± 519 dyne · s · cm−5/m2; p < 0.05). The plasma big endothelin level decreased significantly (PGE1 group, 7.6 ± 3.1 vs 4.7 ± 2.6 fmol/mL; dobutamine group, 6.5 ± 3.7 vs 5.0 ± 2.6 fmol/mL; p < 0.01 for the time effect). Plasma big endothelin (β = 0.393;χ 2 = 10.8; p = 0.001) and SVRI (β = 0.003;χ 2 = 6.9; p < 0.01), both measured after 4 weeks of continuous treatment, were the only independent predictors of future outcome.
Continuous treatment over 4 weeks with either PGE1 or dobutamine in patients awaiting heart transplantation yields an improved hemodynamic state accompanied by a reduction of increased big endothelin levels. Plasma big endothelin measured after 4 weeks of continuous therapy provides prognostic information about future outcome.</abstract><cop>Northbrook, IL</cop><pub>Elsevier Inc</pub><pmid>10858407</pmid><doi>10.1378/chest.117.6.1713</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Alprostadil - administration & dosage Alprostadil - adverse effects Ambulatory Care big endothelin Biological and medical sciences Cardiotonic Agents - administration & dosage Cardiotonic Agents - adverse effects Cardiovascular system dobutamine Dobutamine - administration & dosage Dobutamine - adverse effects Endothelin-1 Endothelins - blood Female heart failure Heart Failure - drug therapy Heart Failure - mortality Heart Failure - physiopathology Heart Transplantation Hemodynamics - drug effects Humans Infusions, Intravenous Long-Term Care Male Medical sciences Middle Aged Miscellaneous Pharmacology. Drug treatments Prognosis Prospective Studies prostaglandin E1 Protein Precursors - blood Survival Rate Vascular Resistance - drug effects Vasodilator Agents - administration & dosage Vasodilator Agents - adverse effects |
| title | Prognostic Value of Hemodynamic vs Big Endothelin Measurements During Long-term IV Therapy in Advanced Heart Failure Patients |
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