Cardiac resynchronization therapy: an option for inotrope-supported patients with end-stage heart failure?
Patients with refractory heart failure requiring inotropic support have a very poor prognosis. Cardiac resynchronization therapy (CRT) offers symptomatic and possibly a survival benefit for patients with stable chronic heart failure (CHF) and a prolonged QRS, but its role in the management of end-st...
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| Veröffentlicht in: | European journal of heart failure 2005-03, Vol.7 (2), p.215-217 |
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| container_title | European journal of heart failure |
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| creator | Cowburn, Peter J Patel, Harshna Jolliffe, Robynn E Wald, Robert W Parker, John D |
| description | Patients with refractory heart failure requiring inotropic support have a very poor prognosis. Cardiac resynchronization therapy (CRT) offers symptomatic and possibly a survival benefit for patients with stable chronic heart failure (CHF) and a prolonged QRS, but its role in the management of end-stage heart failure requiring inotropic support has not been evaluated.
We performed a retrospective observational study of patients undergoing CRT at our institution.
We identified 10 patients who required inotropic support for refractory CHF and who underwent CRT while on intravenous inotropic agents. Patients had been in hospital for 30+/-29 days and had received inotropic support for 11+/-6 days prior to CRT. All patients were weaned from inotropic support (2+/-2 days post-CRT) and all patients survived to hospital discharge (12+/-13 days post-CRT). Furosemide dose fell from 160+/-38 mg on admission to 108+/-53 mg on discharge (p |
| format | Article |
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We performed a retrospective observational study of patients undergoing CRT at our institution.
We identified 10 patients who required inotropic support for refractory CHF and who underwent CRT while on intravenous inotropic agents. Patients had been in hospital for 30+/-29 days and had received inotropic support for 11+/-6 days prior to CRT. All patients were weaned from inotropic support (2+/-2 days post-CRT) and all patients survived to hospital discharge (12+/-13 days post-CRT). Furosemide dose fell from 160+/-38 mg on admission to 108+/-53 mg on discharge (p<0.01). Serum creatinine fell from 192+/-34 micromol/l prior to CRT to 160+/-37 micromol/l on discharge (p<0.05). Serum sodium was 131+/-4 mmol/l prior to CRT and remained low at 132+/-5 mmol/l on discharge. At short-term follow up (mean 47 days), all patients were alive; mean furosemide dose was 130+/-53 mg (p=0.056 versus pre-CRT). Serum creatinine was 157+/-36 micromol/l and serum sodium had increased to 138+/-6 mmol/l (p<0.05 and p<0.01, respectively, versus pre-CRT).
CRT may offer a new therapeutic option for inotrope-supported CHF patients with a prolonged QRS.</description><identifier>ISSN: 1388-9842</identifier><identifier>PMID: 15701469</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Atrial Fibrillation - complications ; Atrial Fibrillation - therapy ; Cardiac Pacing, Artificial ; Cardiotonic Agents - administration & dosage ; Diuretics - administration & dosage ; Dose-Response Relationship, Drug ; Female ; Furosemide - administration & dosage ; Heart Failure - complications ; Heart Failure - therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome</subject><ispartof>European journal of heart failure, 2005-03, Vol.7 (2), p.215-217</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15701469$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cowburn, Peter J</creatorcontrib><creatorcontrib>Patel, Harshna</creatorcontrib><creatorcontrib>Jolliffe, Robynn E</creatorcontrib><creatorcontrib>Wald, Robert W</creatorcontrib><creatorcontrib>Parker, John D</creatorcontrib><title>Cardiac resynchronization therapy: an option for inotrope-supported patients with end-stage heart failure?</title><title>European journal of heart failure</title><addtitle>Eur J Heart Fail</addtitle><description>Patients with refractory heart failure requiring inotropic support have a very poor prognosis. Cardiac resynchronization therapy (CRT) offers symptomatic and possibly a survival benefit for patients with stable chronic heart failure (CHF) and a prolonged QRS, but its role in the management of end-stage heart failure requiring inotropic support has not been evaluated.
We performed a retrospective observational study of patients undergoing CRT at our institution.
We identified 10 patients who required inotropic support for refractory CHF and who underwent CRT while on intravenous inotropic agents. Patients had been in hospital for 30+/-29 days and had received inotropic support for 11+/-6 days prior to CRT. All patients were weaned from inotropic support (2+/-2 days post-CRT) and all patients survived to hospital discharge (12+/-13 days post-CRT). Furosemide dose fell from 160+/-38 mg on admission to 108+/-53 mg on discharge (p<0.01). Serum creatinine fell from 192+/-34 micromol/l prior to CRT to 160+/-37 micromol/l on discharge (p<0.05). Serum sodium was 131+/-4 mmol/l prior to CRT and remained low at 132+/-5 mmol/l on discharge. At short-term follow up (mean 47 days), all patients were alive; mean furosemide dose was 130+/-53 mg (p=0.056 versus pre-CRT). Serum creatinine was 157+/-36 micromol/l and serum sodium had increased to 138+/-6 mmol/l (p<0.05 and p<0.01, respectively, versus pre-CRT).
CRT may offer a new therapeutic option for inotrope-supported CHF patients with a prolonged QRS.</description><subject>Aged</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - therapy</subject><subject>Cardiac Pacing, Artificial</subject><subject>Cardiotonic Agents - administration & dosage</subject><subject>Diuretics - administration & dosage</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Furosemide - administration & dosage</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>1388-9842</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1UEtLxDAYzEFx19W_IDl5K-TVJvUisviCBS97L2nzxWbpJjFJkfXXW3zAwMAwMwxzhtaUK1W1SrAVusz5QAiVhLALtKK1JFQ07RodtjoZpwecIJ_8MKbg3ZcuLnhcRkg6nu6w9jjEH8mGhJ0PJYUIVZ5jDKmAwXEJgC8Zf7oyYvCmykW_Ax5Bp4KtdtOc4P4KnVs9Zbj-4w3aPz3uty_V7u35dfuwq2It2sosw6BtrGCc1cRw2tjeKr6AMTuQhtGe9aKXSpPamrphSteSSq4E0UpK4Bt0-1sbU_iYIZfu6PIA06Q9hDl3jRRUUqUW482fce6PYLqY3FGnU_d_Dv8G_gxg3A</recordid><startdate>20050302</startdate><enddate>20050302</enddate><creator>Cowburn, Peter J</creator><creator>Patel, Harshna</creator><creator>Jolliffe, Robynn E</creator><creator>Wald, Robert W</creator><creator>Parker, John D</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20050302</creationdate><title>Cardiac resynchronization therapy: an option for inotrope-supported patients with end-stage heart failure?</title><author>Cowburn, Peter J ; Patel, Harshna ; Jolliffe, Robynn E ; Wald, Robert W ; Parker, John D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p549-d014e96f423250d316fbf83f8322fc0621b2b4b78a05fd5628a57173840a877e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - therapy</topic><topic>Cardiac Pacing, Artificial</topic><topic>Cardiotonic Agents - administration & dosage</topic><topic>Diuretics - administration & dosage</topic><topic>Dose-Response Relationship, Drug</topic><topic>Female</topic><topic>Furosemide - administration & dosage</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cowburn, Peter J</creatorcontrib><creatorcontrib>Patel, Harshna</creatorcontrib><creatorcontrib>Jolliffe, Robynn E</creatorcontrib><creatorcontrib>Wald, Robert W</creatorcontrib><creatorcontrib>Parker, John D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cowburn, Peter J</au><au>Patel, Harshna</au><au>Jolliffe, Robynn E</au><au>Wald, Robert W</au><au>Parker, John D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiac resynchronization therapy: an option for inotrope-supported patients with end-stage heart failure?</atitle><jtitle>European journal of heart failure</jtitle><addtitle>Eur J Heart Fail</addtitle><date>2005-03-02</date><risdate>2005</risdate><volume>7</volume><issue>2</issue><spage>215</spage><epage>217</epage><pages>215-217</pages><issn>1388-9842</issn><abstract>Patients with refractory heart failure requiring inotropic support have a very poor prognosis. Cardiac resynchronization therapy (CRT) offers symptomatic and possibly a survival benefit for patients with stable chronic heart failure (CHF) and a prolonged QRS, but its role in the management of end-stage heart failure requiring inotropic support has not been evaluated.
We performed a retrospective observational study of patients undergoing CRT at our institution.
We identified 10 patients who required inotropic support for refractory CHF and who underwent CRT while on intravenous inotropic agents. Patients had been in hospital for 30+/-29 days and had received inotropic support for 11+/-6 days prior to CRT. All patients were weaned from inotropic support (2+/-2 days post-CRT) and all patients survived to hospital discharge (12+/-13 days post-CRT). Furosemide dose fell from 160+/-38 mg on admission to 108+/-53 mg on discharge (p<0.01). Serum creatinine fell from 192+/-34 micromol/l prior to CRT to 160+/-37 micromol/l on discharge (p<0.05). Serum sodium was 131+/-4 mmol/l prior to CRT and remained low at 132+/-5 mmol/l on discharge. At short-term follow up (mean 47 days), all patients were alive; mean furosemide dose was 130+/-53 mg (p=0.056 versus pre-CRT). Serum creatinine was 157+/-36 micromol/l and serum sodium had increased to 138+/-6 mmol/l (p<0.05 and p<0.01, respectively, versus pre-CRT).
CRT may offer a new therapeutic option for inotrope-supported CHF patients with a prolonged QRS.</abstract><cop>England</cop><pmid>15701469</pmid><tpages>3</tpages></addata></record> |
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| ispartof | European journal of heart failure, 2005-03, Vol.7 (2), p.215-217 |
| issn | 1388-9842 |
| language | eng |
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| source | MEDLINE; Wiley Free Content; EZB-FREE-00999 freely available EZB journals; Wiley Online Library All Journals |
| subjects | Aged Atrial Fibrillation - complications Atrial Fibrillation - therapy Cardiac Pacing, Artificial Cardiotonic Agents - administration & dosage Diuretics - administration & dosage Dose-Response Relationship, Drug Female Furosemide - administration & dosage Heart Failure - complications Heart Failure - therapy Humans Male Middle Aged Retrospective Studies Treatment Outcome |
| title | Cardiac resynchronization therapy: an option for inotrope-supported patients with end-stage heart failure? |
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