Metolazone in der Behandlung fortgeschrittener therapieresistenter dilatativer Kardiomyopathie
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Metolazone in der Behandlung fortgeschrittener therapieresistenter dilatativer Kardiomyopathie. / Kröger, N; Szuba, J; Frenzel, H.
in: MED KLIN-INTENSIVMED, Jahrgang 86, Nr. 6, 15.06.1991, S. 305-8, 332.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Metolazone in der Behandlung fortgeschrittener therapieresistenter dilatativer Kardiomyopathie
AU - Kröger, N
AU - Szuba, J
AU - Frenzel, H
PY - 1991/6/15
Y1 - 1991/6/15
N2 - Ten patients (eight male/two female) with advanced dilated cardiomyopathy (NYHA III/IV) and a mean fractional shortening in two-dimensional echocardiogram of 20% (9 to 30%) and a mean sodium excretion of 21 mmol (8 to 40 mmol) per day, pretreated with digoxin, captopril and a mean frusemide-dose of 147 mg (80 to 500 mg) without an effective diuresis, were additional treated with 2.5 to 5 mg oral metolazone daily. All patients had a brisk diuresis within 24 hours and a mean weight loss of 8.9 kg (3 to 20 kg) until discharge. All patients improved considerably by additional metolazone-therapy. Seven patients developed a mild hyponatraemia (122 to 132 mmol/l), seven showed mild (greater than or equal to 3.2 mmol/l) and one had a serious hypokalaemia (2.8 mmol/l); spironolactone-pretreated patients developed no hypokalaemia. Notably none of the patients had serious blood pressure fluctuation or a deterioration of renal function. To avoid severe electrolyte-disturbances, additional metolazone-therapy should be practised in hospital, preferring low-dose metolazone and reducing frusemide-dose under careful biochemical monitoring after diuresis is started.
AB - Ten patients (eight male/two female) with advanced dilated cardiomyopathy (NYHA III/IV) and a mean fractional shortening in two-dimensional echocardiogram of 20% (9 to 30%) and a mean sodium excretion of 21 mmol (8 to 40 mmol) per day, pretreated with digoxin, captopril and a mean frusemide-dose of 147 mg (80 to 500 mg) without an effective diuresis, were additional treated with 2.5 to 5 mg oral metolazone daily. All patients had a brisk diuresis within 24 hours and a mean weight loss of 8.9 kg (3 to 20 kg) until discharge. All patients improved considerably by additional metolazone-therapy. Seven patients developed a mild hyponatraemia (122 to 132 mmol/l), seven showed mild (greater than or equal to 3.2 mmol/l) and one had a serious hypokalaemia (2.8 mmol/l); spironolactone-pretreated patients developed no hypokalaemia. Notably none of the patients had serious blood pressure fluctuation or a deterioration of renal function. To avoid severe electrolyte-disturbances, additional metolazone-therapy should be practised in hospital, preferring low-dose metolazone and reducing frusemide-dose under careful biochemical monitoring after diuresis is started.
KW - Aged
KW - Aged, 80 and over
KW - Cardiomyopathy, Dilated
KW - Drug Therapy, Combination
KW - Edema, Cardiac
KW - Female
KW - Furosemide
KW - Heart Failure
KW - Humans
KW - Male
KW - Metolazone
KW - Middle Aged
KW - Sodium
M3 - SCORING: Zeitschriftenaufsatz
C2 - 1886511
VL - 86
SP - 305-8, 332
JO - MED KLIN-INTENSIVMED
JF - MED KLIN-INTENSIVMED
SN - 2193-6218
IS - 6
ER -