Journal of Cardiac Failure
Volume 5, Issue 3 , Pages 195-200 , September 1999

Effect of inotrope withdrawal on morbidity and mortality in patients with chronic heart failure: Results of the vesnarinone trial withdrawal substudy

  • Ozlem Soran, MD

      Affiliations

    • Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
    • ,
  • James D. Young, MD

      Affiliations

    • The Cleveland Clinic Foundation, Cleveland, Ohio, USA
    • ,
  • Richard Holubkov, PhD

      Affiliations

    • Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
    • ,
  • Susan Loftus, RN

      Affiliations

    • Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
    • ,
  • Robert Bourge, MD

      Affiliations

    • The University of Alabama Health Sciences Center, Birmingham, Alabama, USA
    • ,
  • Peter Carson, MD

      Affiliations

    • Georgetown University School of Medicine, Washington, District of Columbia USA
    • ,
  • Brian Jaski, MD

      Affiliations

    • Sharp Hospital, San Diego, California, USA
    • ,
  • B.G. White, PhD

      Affiliations

    • Clinical Cardiovascular Research, Rockville, Maryland, USA
    • ,
  • Arthur M. Feldman, MD, PhD

      Affiliations

    • Corresponding Author InformationReprint requests: Arthur M. Feldman, MD, PhD, 200 Lothrop Street, S-572 Scaife Hall, Pittsburgh, PA 15213.
    • Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
    • ,
  • For The Vest Withdrawal Substudy Group

Received 22 March 1999 ,Revised 4 June 1999 ,Accepted 8 June 1999.

References 

  1. Lejemtel TH, Sonnenblick EH. Should the failing heart be stimulated?. N Engl J Med. 1984;310:1384–1385
  2. Cohn JN. Inotropic therapy for heart failure: paradise postponed. N Engl J Med. 1989;320:729–731
  3. Cody RJ. Do positive inotropic agents adversely affect the survival of patients with chronic congestive heart failure?. In: Introduction. ed 2. J Am Coll Cardiol. 12:1988;p. 559–561
  4. The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA. 1988;259:539–544
  5. Fleg JL, Gottlieb SH, Lakatta EG. Is digoxin really important in treatment of compensated heart failure?. In: A placebo-controlled crossover study in patients with sinus rhythm. ed 2. Am J Med. 73:1982;p. 244–250
  6. Pugh SE, White NJ, Aronson JK, Grahame-Smith DG, Bloomfield JG. Clinical, haemodynamic, and pharmacological effects of withdrawal and reintroduction of digoxin in patients with heart failure in sinus rhythm after long-term treatment. Br Heart J. 1989;61:529–539
  7. Jaeschke R, Oxman AD, Guyatt GH. To what extent do congestive heart failure patients in sinus rhythm benefit from digoxin therapy?. In: A systematic overview and metaanalysis. ed 2. Am J Med. 88:1990;p. 279–286
  8. Packer M, Gheorghiade M, Young JB, Costantini PJ, Adams KF, Cody RJ, et al. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting enzyme inhibitors. In: RADIANCE Study. ed 2. N Engl J Med. 329:1993;p. 1–7
  9. Feldman AM. Pharmacologic properties and clinical evaluation of the new inotropic agent OPC-8212 (vesnarinone). Cardiovasc Drug Rev. 1993;11:1–11
  10. Kass DA, Van Anden E, Becker LC, Kasper EK, White WB, Feldman AM. Dose-dependence of chronic positive inotropic effect of vesnarinone in patients with congestive heart failure due to idiopathic or ischemic cardiomyopathy. Am J Physiol. 1996;78:652–656
  11. Gorcsan J, Murali S, Mandarino WA, Feldman AM. Inotropic effects of vesnarinone in severe heart failure: results of the VEST ventricular function substudy. Circulation. 1998;98:1579–1580
  12. Cohn JN, Goldstein S, Greenberg BH, Lorell BH, Bourge RC, Jaski BE, et al. Dose dependent mortality increase from vesnarinone in severe heart failure: the Vesnarinone Trial results. N Engl J Med. 1998;339:1810–1816
  13. Feldman AM, Bristow MR, Parmley WW, Carson PE, Pepine CJ, Gilbert EM, et al. Effects of vesnarinone on morbidity and mortality in patients with heart failure. N Engl J Med. 1993;329:149–155
  14. Hosokawa T, Mori T, Fujiki H, Kinoshita S, Takemoto K, Imaizumi T, et al. Cardiovascular actions of OPC-18790: a novel positive inotropic agent with little chronotropic action. Heart Vessels. 1992;7:66–75
  15. Takeya K, Yajima M, Kobayashi-Ando S, Ando H. Positive inotropic effect of 3,4-dihydro-6-[4-(3,4-dimethoxybenzoyl)-1-piperazinyl]-2(1H)-quinolinone (OPC8212) and mechanism of action in guinea pig ventricular myocardium. Arzneimittelforschung. 1984;34:364–370
  16. Schwartz A, Wallick ET, Lee SW, Wang T, Hosakawa T, Whitmer KR, et al. Studies on the mechanism of action of 3,4-dihydro-6-[4-(3,4-dimethoxybenzoyl)-1-piperazinyl]-2(1H)-quinolinone (OPC-8212), a new positive inotropic drug. In: Enzyme activities and Ca2+ transport processes of sarcolemma and intracellular organelles. ed 2. Arzneimittelforschung. 34:1984;p. 384–389

☆ Supported in part by Otsuka Pharmaceutical, Osaka, Japan.

PII: S1071-9164(99)90003-9

Journal of Cardiac Failure
Volume 5, Issue 3 , Pages 195-200 , September 1999

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