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Effects of Vasodilator Therapy for Severe Pump Failure in Acute Myocardial Infarction on Short-term and Late Prognosis

Forty-three patients with severe pump failure complicating acute myocardial infarction were treated with vasodilators (nitroprusside (40) and phentolamine (3)) for four hours to 27 days. Cardiac index, stroke volume index, and stroke work index (SWI) increased while the left ventricular filling pres... Full description

Journal Title: Circulation 1976, Vol.53(5), pp.797-802
Main Author: Chatterjee, J. C., Kanu
Other Authors: Swan, S., H. , Kaushik, M. Gary, V. , Jobin, S., D. , Magnusson, S., Peter , Forrester, S., James
Format: Electronic Article Electronic Article
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ID: ISSN: 0009-7322
Link: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00003017-197605000-00010
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title: Effects of Vasodilator Therapy for Severe Pump Failure in Acute Myocardial Infarction on Short-term and Late Prognosis
format: Article
creator:
  • Chatterjee, J. C., Kanu
  • Swan, S., H.
  • Kaushik, M. Gary, V.
  • Jobin, S., D.
  • Magnusson, S., Peter
  • Forrester, S., James
subjects:
  • Medicine
  • Anatomy & Physiology
ispartof: Circulation, 1976, Vol.53(5), pp.797-802
description: Forty-three patients with severe pump failure complicating acute myocardial infarction were treated with vasodilators (nitroprusside (40) and phentolamine (3)) for four hours to 27 days. Cardiac index, stroke volume index, and stroke work index (SWI) increased while the left ventricular filling pressure (LVFP) decreased during vasodilator therapy. Twenty-four of the 43 patients (56%) survived. Of patients with initial SWI between 11–20 gm-m/mi and LVFP < 15 mm Hg, 68% survived. In contrast only 18% of patients with SWI of 10 gm-m/mi or less and LVFP > 15 mm Hg survived. Of the 17 patients with clinical shock, 8 (47%) survived.All 24 patients discharged from the hospital were followed for at least 12 months. Fourteen patients died one to 25 months (average 9.2 months) after discharge and the cause of death was pump failure in ten of them (71%). The ten survivors at last follow-up had been followed for 15 to 32 months (average 24 months). The cumulative survival at 24 months was 28%. Thus, despite improvement in shortterm prognosis with vasodilator therapy in patients with severe pump failure complicating acute myocardial infarction, the prognosis for long term survival remains unfavorable, possibly due to severe intrinsic cardiac damage.
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identifier: ISSN: 0009-7322
fulltext: fulltext
issn:
  • 0009-7322
  • 00097322
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titleEffects of Vasodilator Therapy for Severe Pump Failure in Acute Myocardial Infarction on Short-term and Late Prognosis
creatorChatterjee, J. C., Kanu ; Swan, S., H. ; Kaushik, M. Gary, V. ; Jobin, S., D. ; Magnusson, S., Peter ; Forrester, S., James
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identifierISSN: 0009-7322
descriptionForty-three patients with severe pump failure complicating acute myocardial infarction were treated with vasodilators (nitroprusside (40) and phentolamine (3)) for four hours to 27 days. Cardiac index, stroke volume index, and stroke work index (SWI) increased while the left ventricular filling pressure (LVFP) decreased during vasodilator therapy. Twenty-four of the 43 patients (56%) survived. Of patients with initial SWI between 11–20 gm-m/mi and LVFP < 15 mm Hg, 68% survived. In contrast only 18% of patients with SWI of 10 gm-m/mi or less and LVFP > 15 mm Hg survived. Of the 17 patients with clinical shock, 8 (47%) survived.All 24 patients discharged from the hospital were followed for at least 12 months. Fourteen patients died one to 25 months (average 9.2 months) after discharge and the cause of death was pump failure in ten of them (71%). The ten survivors at last follow-up had been followed for 15 to 32 months (average 24 months). The cumulative survival at 24 months was 28%. Thus, despite improvement in shortterm prognosis with vasodilator therapy in patients with severe pump failure complicating acute myocardial infarction, the prognosis for long term survival remains unfavorable, possibly due to severe intrinsic cardiac damage.
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titleEffects of Vasodilator Therapy for Severe Pump Failure in Acute Myocardial Infarction on Short-term and Late Prognosis
descriptionForty-three patients with severe pump failure complicating acute myocardial infarction were treated with vasodilators (nitroprusside (40) and phentolamine (3)) for four hours to 27 days. Cardiac index, stroke volume index, and stroke work index (SWI) increased while the left ventricular filling pressure (LVFP) decreased during vasodilator therapy. Twenty-four of the 43 patients (56%) survived. Of patients with initial SWI between 11–20 gm-m/mi and LVFP < 15 mm Hg, 68% survived. In contrast only 18% of patients with SWI of 10 gm-m/mi or less and LVFP > 15 mm Hg survived. Of the 17 patients with clinical shock, 8 (47%) survived.All 24 patients discharged from the hospital were followed for at least 12 months. Fourteen patients died one to 25 months (average 9.2 months) after discharge and the cause of death was pump failure in ten of them (71%). The ten survivors at last follow-up had been followed for 15 to 32 months (average 24 months). The cumulative survival at 24 months was 28%. Thus, despite improvement in shortterm prognosis with vasodilator therapy in patients with severe pump failure complicating acute myocardial infarction, the prognosis for long term survival remains unfavorable, possibly due to severe intrinsic cardiac damage.
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abstractForty-three patients with severe pump failure complicating acute myocardial infarction were treated with vasodilators (nitroprusside (40) and phentolamine (3)) for four hours to 27 days. Cardiac index, stroke volume index, and stroke work index (SWI) increased while the left ventricular filling pressure (LVFP) decreased during vasodilator therapy. Twenty-four of the 43 patients (56%) survived. Of patients with initial SWI between 11–20 gm-m/mi and LVFP < 15 mm Hg, 68% survived. In contrast only 18% of patients with SWI of 10 gm-m/mi or less and LVFP > 15 mm Hg survived. Of the 17 patients with clinical shock, 8 (47%) survived.All 24 patients discharged from the hospital were followed for at least 12 months. Fourteen patients died one to 25 months (average 9.2 months) after discharge and the cause of death was pump failure in ten of them (71%). The ten survivors at last follow-up had been followed for 15 to 32 months (average 24 months). The cumulative survival at 24 months was 28%. Thus, despite improvement in shortterm prognosis with vasodilator therapy in patients with severe pump failure complicating acute myocardial infarction, the prognosis for long term survival remains unfavorable, possibly due to severe intrinsic cardiac damage.
pub© 1976 American Heart Association, Inc.
doi10.1161/01.CIR.53.5.797
eissn15244539
date1976-05