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Intermittent dobutamine therapy in patients with advanced congestive heart failure

C Ferroni1, A Fraticelli, E Paciaroni

  • 1Cardiology Department, I.N.R.C.A.-I.R.C.S.S., Via della Montagnola, 164, I-60131 Ancona, Italy.

Archives of Gerontology and Geriatrics
|November 1, 1996
PubMed

Insights

Intermittent dobutamine infusions may improve quality of life for elderly patients with advanced congestive heart failure (CHF). This treatment reduced hospitalizations and improved functional class, despite high mortality rates in the study group.

Area of Science:

  • Cardiology
  • Pharmacology
  • Geriatrics

Background:

  • Congestive heart failure (CHF) is a growing public health concern with significant morbidity and mortality.
  • Current treatments for advanced CHF, especially in the elderly, are limited, with heart transplantation being rarely feasible.
  • Improved pharmacological strategies are needed to manage CHF patients and enhance their quality of life.

Purpose of the Study:

  • To evaluate the efficacy and safety of intermittent dobutamine infusions in elderly patients with advanced, ischemic congestive heart failure (NYHA Class IV).
  • To assess the impact of dobutamine treatment on mortality, cardiovascular events, and functional status.

Main Methods:

  • A randomized study involving 24 elderly patients (mean age 75.9 years) with advanced CHF.
  • Intermittent infusions of dobutamine (2, 4, or 6 microg/kg/min for 36 hours every 2-4 weeks) were administered.
  • Patients were followed for an average of ten months, with data collected on mortality, cardiovascular events, and NYHA functional classification.

Main Results:

  • While 12-month mortality remained high at 50%, patients showed improvement in NYHA functional classification during follow-up.
  • A significant decrease in the need for hospitalization was observed in the treated group.
  • Side effects were infrequent, with only two patients discontinuing treatment due to adverse events.

Conclusions:

  • Intermittent dobutamine infusion appears to be a viable treatment option for elderly patients suffering from advanced congestive heart failure refractory to conventional therapies.
  • The treatment demonstrated benefits in functional status and reduced hospitalizations, suggesting a potential role in palliative care for this population.

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