重度の心不全の長期治療のためのミルリノーン:最大限の運動耐久性に特に言及した臨床経験

T H LeJemtel, D Gumbardo, B Chadwick

Circulation

|March 1, 1986

まとめ

ミルリノンは重度の慢性心不全患者の健康状態を改善しましたが,運動能力は増加しませんでした. カプトプリル添加も症状の緩和をもたらしたが,死亡率は依然として懸念事項である.

科学分野:

心臓病学心臓病学
薬理学薬理学とは

背景:

重度の慢性心不全は,管理に重大な課題をもたらす.
既存の治療法は,患者の治療結果と生活の質を改善する上で限界があります.

研究の目的:

重度の慢性心不全の患者におけるミルリノンの長期療法の有効性と安全性を評価する.
耐火性の症例において,ミルリノーンにカプトプリルを加える効果を評価する.

主な方法:

37人の重度の慢性心不全患者の公開試験.
ミルリノンの初期用量は1日20〜30mgで,最大50mgまで調整されます.
カプトプリルは,症状が制御されていない15人の患者に追加されました.

主要な成果:

患者の67%がミルリノーンで幸福感の改善 (呼吸不全/疲労の減少) を報告したが,最大酸素摂取量は有意に増加しなかった.
症状の再発は,投与量増加によって部分的に逆転した; 67%の患者は,加えたカプトプリルで改善した.
ミルリノンの明らかな副作用はありませんが,左心室の終末ダイアストリック寸法が増加しました (p < .05).

結論:

ミルリノンの長期療法は,明らかな副作用なしに,重度の慢性心不全の機能的状態を改善することができます.
観察された高い死亡率に対するミルリノンの潜在的な貢献は排除できない.
カプトプリルとの併用治療は,一部の耐火性症例において,症状的な利点をもたらします.

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