Why the study?
Does low-dose amiodarone improve surrogate markers and is it tolerated in patients with advanced heart failure who are intolerant of beta-blockers?
Does low-dose amiodarone improve surrogate markers and is it tolerated in patients with advanced heart failure who are intolerant of beta-blockers?
Low-dose amiodarone may improve heart rate, BNP, and fractional shortening in patients with advanced heart failure intolerant to beta-blockers, though it carries a risk of exacerbating heart failure in some patients.
Answers are grounded in this paper and cite their sources.
May warrant prospective trials in beta-blocker intolerant HF; hypothesis-generating and should not yet change practice.
The tolerability and effectiveness of amiodarone in patients with advanced heart failure (HF) who are intolerant of beta-blockers was investigated in 22 patients (13 with and 9 without 180+/-26 mg/day of amiodarone). Heart rate (HR), blood pressure (BP), left ventricular diastolic dimension and fractional shortening (FS) using echocardiography, plasma atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and norepinephrine concentrations were determined at baseline and after 1 and 3 months of therapy. Although 9 patients tolerated amiodarone without any signs of HF, it was exacerbated in 4 patients. In 10 patients taking amiodarone who could be followed medically for 3 months, HR decreased after 1 month and remained unchanged until after 3 months (81+/-12 vs 65+/-7 vs 65+/-7beats/min), accompanied by decreased concentration of BNP (688+/-485 vs 392+/-203 vs 261+/-192pg/ml). FS increased significantly only after 3 months (0.12+/-0.05 vs 0.14+/-0.05 vs 0.16+/-0.04). Amiodarone may be used in patients with advanced HF who are intolerant of beta-blockers.
No takes yet. Share an insight, caveat, or question.
Takemura et al. (2002) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: