Showing papers by "Mariell Jessup published in 1987"
TL;DR: Restingleft ventricular function is well preserved in patients with pulmonary hypertension, despite significant alterations in septal position and left ventricular size, according to computer-assisted analysis of M-mode echocardiograms obtained within 24 hours of a hemodynamic study.
68 citations
TL;DR: To examine the short-term hemodynamic and long-term clinical effects of oral enoximone at low doses, 12 patients with severe, chronic congestive heart failure (CHF) were given 1 mg/kg oral en oximone and followed with serial hemodynamic measurements for 24 hours.
Abstract: To examine the short-term hemodynamic and long-term clinical effects of oral enoximone at low doses, 12 patients with severe, chronic congestive heart failure (CHF) were given 1 mg/kg oral enoximone and followed with serial hemodynamic measurements for 24 hours. Control cardiac index was 1.9 +/- 0.5 liters/min/m2 and it increased significantly by 1 hour, with a peak effect at 2 hours to 2.4 +/- 0.4 liters/min/m2 (p less than 0.05). Similarly, wedge pressure, 22 +/- 8 mm Hg at control, decreased to 16 +/- 10 by 1 hour (p less than 0.05). Six of the 12 patients received 1 mg/kg of enoximone on day 1 and 2 mg/kg on day 2. The higher dose of enoximone caused no further improvement in cardiac performance but prolonged the salutary hemodynamic effect. Subsequently, 79 patients (18 in New York Heart Association class III and 61 in class IV) with CHF (ejection fraction 17 +/- 8%) were followed over a 3 year period; the average enoximone dose was 1.7 +/- 0.7 mg/kg 3 times daily. Improvement of at least 1 functional class occurred in 55 patients (70%) at 1 month, 27 patients (34%) at 6 months and 19 (24%) maintained their improvement for over 1 year. Enoximone was discontinued in 20 patients (25%); in 5 (6%) for adverse effects and in 13 patients because of no clinical benefit. Adverse effects occurred in 14 patients (18%); 6% of all patients required discontinuation of drug. Six month survival was 50%, 42% at 1 year and 30% at 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)
12 citations
01 Jan 1987
TL;DR: The purpose of this report will be to review the problems associated with the current efforts to objectively quantitate the effect of therapy on the signs, symptoms, exercise tolerance and general well-being of the patient with chronic cardiac failure.
Abstract: The symptom complex of chronic congestive heart failure is primarily composed of generalized fatigue and dyspnea, resulting in a limitation of exercise capability. In addition to the extensive morbidity associated with the disease, there is a growing appreciation of the excessive mortality that occurs in a population of patients with symptomatic heart failure. Thus, 2 fundamental goals of therapy for the patient with congestive heart failure are to improve the quality of life and to extend survival. Although measuring the impact of a therapy on mortality involves the evaluation of large numbers of patients followed for long periods of time, the endpoint of death is simple, unambiguous and without controversy. The same can not be said of the assessment of changes in quality of life. The purpose of this report will be to review the problems associated with our current efforts to objectively quantitate the effect of therapy on the signs, symptoms, exercise tolerance and general well-being of the patient with chronic cardiac failure.