The use of milrinone for curing a chronic heart failure

Runali R. Bharati; Shaymlila B.Bavage; Nandkishor B.Bavage

The use of milrinone for curing a chronic heart failure

Authors: Runali R. Bharati, Shaymlila B.Bavage, Nandkishor B.Bavage

Unique Paper ID: 152408
Volume: 8
Issue: 3
PageNo: 102-105

Keywords: Adrenergic beta-antagonists heart failure congestive milrinone

Abstract:
Phosphodiesterase inhibitors such as milrinone can relieve symptoms and improve hemodynamics in patients with advanced congestive heart failure. We retrospectively evaluated the hemodynamic and clinical outcomes of long-term combination therapy with intravenous milrinone and oral Î²-blockers in 65 patients with severe congestive heart failure (New York Heart Association class IV function and ejection fraction <25%) refractory to oral medical therapy. Fifty-one patients successfully began Î²-blocker therapy while on intravenous milrinone. Oral medical therapy was maximized when possible. The mean duration of milrinone treatment in this combination-treatment group was 269 days (range, 14â€“1,026 days). Functional class improved from IV to IIâ€“III with milrinone therapy. Twenty-four such patients tolerated Î²-blocker up-titration and were successfully weaned from milrinone. Sixteen patients (31%) died while receiving combination therapy; one died of sudden cardiac death (on treatment day 116); the other 15 died of progressive heart failure or other complications. Hospital admissions during the previous 6 months and admissions within 6 months after milrinone initiation stayed the same. Meanwhile, the total number of hospital days decreased from 450 to 380 (a 15.6% reduction), and the mean length of stay decreased by 1.4 days (a 14.7% reduction). We conclude that 1) milrinone plus Î²-blocker combination therapy is an effective treatment for heart failure even with Î²-blocker up-titration, 2) weaning from milrinone may be possible once medications are maximized, 3) patients' functional status improves on the combination regimen, and 4) treatment-related sudden death is relatively infrequent during the combination regimen.

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Cite This Article

ISSN: 2349-6002
Volume: 8
Issue: 3
PageNo: 102-105

The use of milrinone for curing a chronic heart failure

Available:https://ijirt.org/Article?manuscript=152408

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