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[Metolazone in the treatment of advanced therapy-resistant dilated cardiomyopathy]. / Metolazone in der Behandlung fortgeschrittener therapieresistenter dilatativer Kardiomyopathie.
Kröger, N; Szuba, J; Frenzel, H.
Afiliación
  • Kröger N; Medizinische Abteilung, Israelitischen Krankenhauses, in Hamburg.
Med Klin (Munich) ; 86(6): 305-8, 332, 1991 Jun 15.
Article en De | MEDLINE | ID: mdl-1886511
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.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiomiopatía Dilatada / Metolazona Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: De Revista: Med Klin (Munich) Año: 1991 Tipo del documento: Article Pais de publicación: Alemania
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiomiopatía Dilatada / Metolazona Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: De Revista: Med Klin (Munich) Año: 1991 Tipo del documento: Article Pais de publicación: Alemania