title: Low-dose amiodarone for patients with advanced heart failure who are intolerant of beta-blockers.
abstract: 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.
authors.affiliation: Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Takemura
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yasumura
authors.forename: Keiji
authors.initials: K
authors.lastname: Hirooka
authors.forename: Akihisa
authors.initials: A
authors.lastname: Hanatani
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakatani
authors.forename: Kazuo
authors.initials: K
authors.lastname: Komamura
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Kunio
authors.initials: K
authors.lastname: Miyatake
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000638:Amiodarone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D009320:Atrial Natriuretic Factor / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D002303:Cardiac Output, Low / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D019233:Retreatment; D012720:Severity of Illness Index
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D000638:Amiodarone