HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Nanas, J. N. Articles by Anastasiou-Nana, M. I. Search for Related Content PubMed PubMed Citation Articles by Nanas, J. N. Articles by Anastasiou-Nana, M. I.

Long-term Intermittent Dobutamine Infusion, Combined With Oral Amiodarone for End-Stage Heart Failure^*

A Randomized Double-Blind Study

^* From the University of Athens School of Medicine, Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece.

Correspondence to: John N. Nanas, MD, Makedonias 24, 104 33 Athens, Greece; e-mail: jnanas{at}ath.forthnet.gr

Study objectives: To examine the effects of long-term intermittent dobutamine infusion, combined with oral amiodarone in patients with congestive heart failure (CHF) refractory to standard medical treatment.

Design: Prospective, randomized, double-blind, placebo-controlled clinical trial.

Setting: Inpatient and outpatient heart failure clinic in a university teaching hospital.

Patients and interventions: Thirty patients with end-stage CHF refractory to standard medical treatment who could be weaned from dobutamine therapy after a first 72-h infusion were randomized in a double-blind manner to receive IV infusions of placebo (group 1; 14 patients) vs dobutamine in a dose of 10 µg/kg/min (group 2; 16 patients) for 8 h every 14 days. All patients received standard medical therapy and also were treated with oral amiodarone, 400 mg/d, which was started at least 2 weeks before randomization.

Measurements and results: Kaplan-Meier survival analysis showed a 60% reduction in the risk of death from any cause in the group treated with the combination of dobutamine and amiodarone, compared with the group treated with placebo and amiodarone (hazard ratio, 0.403; 95% confidence interval, 0.164 to 0.992; p = 0.048). The 1-year and 2-year survival rates were 69% and 44%, respectively, in the dobutamine-treated group, vs 28% and 21%, respectively, in the placebo-treated group (p < 0.05 for both comparisons). Median survival times were 574 and 144 days, respectively, for groups 2 and 1. At 6 months, the New York Heart Association functional class was significantly improved in the patients who survived from both groups.

Conclusions: Long-term intermittent dobutamine infusion combined with amiodarone added to the conventional drugs improved the survival of patients with advanced CHF that was refractory to conventional treatment.

Key Words: heart failure • inotropic agents • survival

This article has been cited by other articles:

				I. Malik JournalScan Heart, September 1, 2004; 90(9): 1101 - 1102. [Full Text] [PDF]

eLetters: