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Normalization of ejection fraction and resolution of symptoms in chronic severe heart failure is possible with modern medical therapy: clinical observations in 11 patients.
Am J Ther 2008 May-Jun; 15(3):206-13AJ

Abstract

This report describes the normalization of left ventricular ejection fraction and resolution of signs and symptoms of chronic and severe heart failure in both male and female patients (mean age 54 years) treated with standard medical therapy. These observations were made in 11 patients with idiopathic dilated cardiomyopathy treated in a single cardiology practice, who had evidence of myocardial "viability" (dysfunctional but noncontractile myocardium that has the potential for improvement in function) as assessed by cardiac magnetic resonance imaging, low-dose dobutamine echocardiography, or nuclear imaging. These patients were treated with standard available therapies including beta-blockers, angiotensin-converting enzyme inhibitors, digoxin, and potassium and non-potassium-sparing diuretics. The average ejection fraction at presentation was 17% +/- 9% which improved to 59% +/- 5%. All patients improved to New York Heart Association functional class I with available therapy. The majority of patients received micronutrient supplementation with coenzyme Q10, vitamin B1, and amino acids, which target the pathways of cardiac metabolism and may aid in the restoration of cardiac function. This case series demonstrates that normalization of cardiac function is possible with standard therapy and the importance of assessing myocardial viability in all patients with heart failure and reduced ejection fraction. Given the unique metabolic needs of the failing heart, the role of micronutrients in combination with standard therapy warrants further investigation.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

18496257

Citation

Harinstein, Matthew E., et al. "Normalization of Ejection Fraction and Resolution of Symptoms in Chronic Severe Heart Failure Is Possible With Modern Medical Therapy: Clinical Observations in 11 Patients." American Journal of Therapeutics, vol. 15, no. 3, 2008, pp. 206-13.
Harinstein ME, Berliner JI, Shah SJ, et al. Normalization of ejection fraction and resolution of symptoms in chronic severe heart failure is possible with modern medical therapy: clinical observations in 11 patients. Am J Ther. 2008;15(3):206-13.
Harinstein, M. E., Berliner, J. I., Shah, S. J., Taegtmeyer, H., & Gheorghiade, M. (2008). Normalization of ejection fraction and resolution of symptoms in chronic severe heart failure is possible with modern medical therapy: clinical observations in 11 patients. American Journal of Therapeutics, 15(3), pp. 206-13. doi:10.1097/MJT.0b013e3181728a1d.
Harinstein ME, et al. Normalization of Ejection Fraction and Resolution of Symptoms in Chronic Severe Heart Failure Is Possible With Modern Medical Therapy: Clinical Observations in 11 Patients. Am J Ther. 2008;15(3):206-13. PubMed PMID: 18496257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Normalization of ejection fraction and resolution of symptoms in chronic severe heart failure is possible with modern medical therapy: clinical observations in 11 patients. AU - Harinstein,Matthew E, AU - Berliner,Jennifer I, AU - Shah,Sanjiv J, AU - Taegtmeyer,Heinrich, AU - Gheorghiade,Mihai, PY - 2008/5/23/pubmed PY - 2008/7/2/medline PY - 2008/5/23/entrez SP - 206 EP - 13 JF - American journal of therapeutics JO - Am J Ther VL - 15 IS - 3 N2 - This report describes the normalization of left ventricular ejection fraction and resolution of signs and symptoms of chronic and severe heart failure in both male and female patients (mean age 54 years) treated with standard medical therapy. These observations were made in 11 patients with idiopathic dilated cardiomyopathy treated in a single cardiology practice, who had evidence of myocardial "viability" (dysfunctional but noncontractile myocardium that has the potential for improvement in function) as assessed by cardiac magnetic resonance imaging, low-dose dobutamine echocardiography, or nuclear imaging. These patients were treated with standard available therapies including beta-blockers, angiotensin-converting enzyme inhibitors, digoxin, and potassium and non-potassium-sparing diuretics. The average ejection fraction at presentation was 17% +/- 9% which improved to 59% +/- 5%. All patients improved to New York Heart Association functional class I with available therapy. The majority of patients received micronutrient supplementation with coenzyme Q10, vitamin B1, and amino acids, which target the pathways of cardiac metabolism and may aid in the restoration of cardiac function. This case series demonstrates that normalization of cardiac function is possible with standard therapy and the importance of assessing myocardial viability in all patients with heart failure and reduced ejection fraction. Given the unique metabolic needs of the failing heart, the role of micronutrients in combination with standard therapy warrants further investigation. SN - 1536-3686 UR - https://www.unboundmedicine.com/medline/citation/18496257/Normalization_of_ejection_fraction_and_resolution_of_symptoms_in_chronic_severe_heart_failure_is_possible_with_modern_medical_therapy:_clinical_observations_in_11_patients_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=18496257.ui DB - PRIME DP - Unbound Medicine ER -