[Clinical significance of the function of adrenal cortex in refractory congestive heart failure].
OBJECTIVE
To investigate the function of adrenal cortex in refractory congestive heart failure and to testify the hypothesis that glucocorticosteroid can improve the effectiveness of medicine on this disease.


METHODS
Thirty-eight patients with refractory congestive heart failure (men 23 and women 15) were enrolled in this study and randomly divided into two groups, control group and treatment group. The cardiac index and ejection fraction were applied to evaluate the cardiac function and the level of blood cortisol was used to estimate the adrenal cortex function.


RESULTS
The level of blood cortisol was low at the time of hospitalization in all studied patients. Moreover, the digoxin, diuretic and vasodilating had little effective ness in those patients. However, the glucocorticosteroid at a low dosage was able to improve the effectiveness of those medicines on congestive heart failure. The cardiac index, left ventricular ejection fraction and urine output dramatically increased after glucocorticosteroid treatment. There was a significant difference between the treatment group and control group (23.8 percent vs. 70.6 percent, P<0.01). In addition, the mortality in treatment  group was also lower than that in control group (38.1 percent vs. 58.8 percent, P>0.05).


CONCLUSIONS
Glucocorticosteroid at a low dosage obviously improved the effectiveness of medicines on congestive heart failure, and increased the survival rate in the patients.
Lu
Liang
L
Cardiovascular Department, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China.
Li
Wei-min
WM
D000302:Adrenal Cortex / Q000187:drug effects / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D013318:Stroke Volume; D014556:Urine
D005938:Glucocorticoids; D006854:Hydrocortisone