论文信息 - Pharmacologic Treatment of Congestive Heart Failure-Reply

Pharmacologic Treatment of Congestive Heart Failure-Reply

In Reply. —We appreciate the comments of Dr Ahmad, Dr Anderson, and Dr Oosterbosch, expressed in an effort to improve the recommendations within the recent Agency for Health Care Policy and Research clinical practice guideline on heart failure1and in our recent publication inThe Journal. Ahmad raises the potential value of low-dose amiodarone. At this time, we do not believe that sufficient data exist to reach a consensus regarding the role of low-dose amiodarone for prolonging survival in heart failure. Currently available data are conflicting. A promising study, showing improved survival with amiodarone,2was published subsequent to the publication of the guideline. However, the study by Nicklas et al3referenced by Ahmad showed no clinical benefit. We believe that more data are needed to determine whether routine use of this agent is warranted. We concur with the comments of Anderson regarding the importance of magnesium replacement

D. Baker | M. Konstam

[1] Craig D. Miller,et al. Management of Patients With Intramural Hematoma of the Thoracic Aorta , 1993, Circulation.

[2] W. Mckenna,et al. Prospective, double-blind, placebo-controlled trial of low-dose amiodarone in patients with severe heart failure and asymptomatic frequent ventricular ectopy. , 1991, American heart journal.

[3] H. Doval,et al. Randomised trial of low-dose amiodarone in severe congestive heart failure , 1994, The Lancet.

[4] M A Konstam,et al. Heart failure: evaluation and care of patients with left ventricular systolic dysfunction. , 1995, Journal of cardiac failure.

[5] C. Benedict,et al. Progression of left ventricular dysfunction secondary to coronary artery disease, sustained neurohormonal activation and effects of ibopamine therapy during long-term therapy with angiotensin-converting enzyme inhibitor. , 1994, The American journal of cardiology.