É necessário suspender o betabloqueador na insuficiência cardíaca descompensada com baixo débito?

Lima, Marcelo; Cardoso, Juliano Novaes; Ochiai, Marcelo Eidi; Grativvol, Katiuska Massucatti; Grativvol, Petherson Susano; Brancalhão, Euler; Munhoz, Robinson Tadeu; Morgado, Paulo; Scipioni, Airton R.; Barretto, Antônio Carlos Pereira

doi:10.1590/s0066-782x2010005000108

Cited by 5 publications

(5 citation statements)

References 21 publications

(28 reference statements)

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“…In our institution, ACEI and beta-blockers are not systematically withdrawn at hospitalization for cardiac decompensation 12 . In general, ACEI have their dose increased, as vasoconstriction is the major pathophysiological alteration in cardiac decompensation.…”

Section: Discussionmentioning

confidence: 99%

Temporal Variation in the Prognosis and Treatment of Advanced Heart Failure - Before and After 2000

Carlo¹,

Cardoso²,

Ochia³

et al. 2014

Arquivos Brasileiros De Cardiologia

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BackgroundThe treatment of heart failure has evolved in recent decades suggesting that survival is increasing.ObjectiveTo verify whether there has been improvement in the survival of patients with advanced heart failure.MethodsWe retrospectively compared the treatment and follow-up data from two cohorts of patients with systolic heart failure admitted for compensation up to 2000 (n = 353) and after 2000 (n = 279). We analyzed in-hospital death, re-hospitalization and death in 1 year of follow-up. We used Mann-Whitney U test and chi-square test for comparison between groups. The predictors of mortality were identified by regression analysis through Cox proportional hazards model and survival analysis by the Kaplan-Meier survival analysis.ResultsThe patients admitted until 2000 were younger, had lower left ventricular impairment and received a lower proportion of beta-blockers at discharge. The survival of patients hospitalized before 2000 was lower than those hospitalized after 2000 (40.1% vs. 67.4%; p<0.001). The independent predictors of mortality in the regression analysis were: Chagas disease (hazard ratio: 1.9; 95% confidence interval: 1.3-3.0), angiotensin-converting-enzyme inhibitors (hazard ratio: 0.6; 95% confidence interval: 0.4-0.9), beta-blockers (hazard ratio: 0.3; 95% confidence interval: 0.2-0.5), creatinine ≥ 1.4 mg/dL (hazard ratio: 2.0; 95% confidence interval: 1.3-3.0), serum sodium ≤ 135 mEq/L (hazard ratio: 1.8; 95% confidence interval: 1.2-2.7).ConclusionsPatients with advanced heart failure showed a significant improvement in survival and reduction in re-hospitalizations. The neurohormonal blockade, with angiotensin-converting-enzyme inhibitors and beta-blockers, had an important role in increasing survival of these patients with advanced heart failure.

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Section: Discussionmentioning

confidence: 99%

Temporal Variation in the Prognosis and Treatment of Advanced Heart Failure - Before and After 2000

Carlo¹,

Cardoso²,

Ochia³

et al. 2014

Arquivos Brasileiros De Cardiologia

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“…The finding that beta-blockers can be used concomitantly with dobutamine is of great interest and has been studied by several authors in recent years [1][2][3][4][5] . This paper objectively presents a prospective study of 44 patients hospitalized for heart failure decompensation who required the use of inotropic agents.…”

Section: Replymentioning

confidence: 99%

“…This paper objectively presents a prospective study of 44 patients hospitalized for heart failure decompensation who required the use of inotropic agents. So far, there have been no reports of a randomized study comparing the retention or suspension of beta-blocker when dobutamine is used in decompensation; however, there is evidence that maintenance of beta-blockers reduce mortality of these patients [1][2][3][4] .…”

Section: Replymentioning

confidence: 99%

Betabloqueador e dobutamina na insuficiência cardíaca: uma combinação segura?

Santos¹,

Barbosa²,

Passos³

2011

Arq. Bras. Cardiol.

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“…A pericardite constritiva é uma doença pouco frequente e seu diagnóstico muitas vezes é feito tardiamente. 1 A pericardiectomia radical é o procedimento mais indicado em casos de pericardite constritiva, 2 entretanto, trata-se de uma cirurgia complexa e demorada. Estes aspectos são potencialmente interessantes para o uso da impressão 3D no planejamento cirúrgico, pois o estudo do modelo impresso pela equipe de saúde permite melhor compreensão da área cirúrgica, obtendo um planejamento mais eficiente.…”

Section: Introductionunclassified