Abstract |
17 patients with New York Heart Association (NYHA) class IV congestive cardiac failure, refractory to conventional treatment, were additionally treated with oral metolazone (1.25-10 mg daily). 12 improved sufficiently to be discharged from hospital (NYHA class II or III, mean weight loss 8.3 kg), 1 of whom died at home 4 weeks later. The other 5 patients were treated with intravenous dobutamine for 72 h; 2 responded (average weight loss 4.4 kg), and 2 responded to subsequent reintroduction of metolazone. 4 of these 5 patients died, 2 in hospital of acute myocardial infarction. Overall, 15 patients with very severe refractory cardiac failure improved sufficiently to be discharged from hospital. Treatment was associated with mild transient hypokalaemia in 7 patients, and hyponatraemia and renal impairment in 1, for whom metolazone dosage had to be reduced. Failure to respond to the introduction of metolazone may indicate an especially poor prognosis.
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Authors | A Kiyingi, M J Field, C C Pawsey, J Yiannikas, J R Lawrence, W J Arter |
Journal | Lancet (London, England)
(Lancet)
Vol. 335
Issue 8680
Pg. 29-31
(Jan 06 1990)
ISSN: 0140-6736 [Print] England |
PMID | 1967337
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Diuretics
- Dobutamine
- Metolazone
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Topics |
- Aged
- Aged, 80 and over
- Body Weight
(drug effects)
- Clinical Trials as Topic
- Diuresis
(drug effects)
- Diuretics
(therapeutic use)
- Dobutamine
(administration & dosage, therapeutic use)
- Drug Evaluation
- Drug Therapy, Combination
- Female
- Follow-Up Studies
- Heart Failure
(drug therapy)
- Humans
- Infusions, Intravenous
- Male
- Metolazone
(administration & dosage, adverse effects, therapeutic use)
- Middle Aged
- Prognosis
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