Kourek Christos, Xanthopoulos Andrew, Giamouzis Grigorios, Parisis Charalambos, Briasoulis Alexandros, Magouliotis Dimitrios E, Triposkiadis Filippos, Skoularigis John
Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), 11521 Athens, Greece.
Department of Cardiology, University Hospital of Larissa, 41110 Larissa, Greece.
J Clin Med. 2024 Sep 24;13(19):5667. doi: 10.3390/jcm13195667.
: Many clinical trials have shown beneficial effects of low-dose dopamine on renal function, diuresis and symptom relief, or cardiac function in hospitalized patients with acute decompensated heart failure (HF). The aim is to assess the neurohormonal effects and the effects on clinical outcomes of the addition of low-dose dopamine in furosemide treatment in patients hospitalized for acute decompensated HF. : A total of 62 patients hospitalized for acute decompensation of HF, were randomly allocated to one of the following three groups: i. LDF (low-dose furosemide), ii. HDF (high-dose furosemide) and, iii. LDFD (low-dose furosemide and dopamine). Primary outcomes of the present analysis were biochemical and neurohormonal indices (i.e., urea, creatinine, hemoglobin, electrolytes, natriuretic peptides, troponin, renin, angiotensin, aldosterone, adrenaline, noradrenaline). Secondary endpoints included clinical outcomes (i.e., length of stay, in-hospital mortality, 2-month mortality and rehospitalization, and 1-year mortality and rehospitalization). : Urea and creatinine levels were similar for each day among the three groups ( > 0.05). The amount of urine was similar among the three groups per measurement at 2, 4, 6 and at 8 h ( > 0.05). Biochemical and neurohormonal indices as well as clinical outcomes did not differ among patients receiving different doses of furosemide, nor in patients receiving furosemide in combination with dopamine ( > 0.05). : Although the addition of low-dose dopamine to intravenous furosemide was considered to have some theoretical advantages in maintaining renal function, no significant differences in neurohormonal effects and clinical outcomes were observed in patients hospitalized for acute decompensation of HF.
许多临床试验表明,低剂量多巴胺对急性失代偿性心力衰竭(HF)住院患者的肾功能、利尿和症状缓解或心脏功能具有有益作用。目的是评估在急性失代偿性HF住院患者中,低剂量多巴胺联合速尿治疗对神经激素的影响以及对临床结局的影响。:共有62例因急性失代偿性HF住院的患者,被随机分配到以下三组之一:i. LDF(低剂量速尿),ii. HDF(高剂量速尿),iii. LDFD(低剂量速尿和多巴胺)。本分析的主要结局是生化和神经激素指标(即尿素、肌酐、血红蛋白、电解质、利钠肽、肌钙蛋白、肾素、血管紧张素、醛固酮、肾上腺素、去甲肾上腺素)。次要终点包括临床结局(即住院时间、院内死亡率、2个月死亡率和再住院率,以及1年死亡率和再住院率)。:三组中每天的尿素和肌酐水平相似(>0.05)。在2、4、6和8小时的每次测量中,三组的尿量相似(>0.05)。接受不同剂量速尿的患者之间,以及接受速尿联合多巴胺的患者之间,生化和神经激素指标以及临床结局均无差异(>0.05)。:尽管在静脉注射速尿中添加低剂量多巴胺被认为在维持肾功能方面具有一些理论优势,但在因急性失代偿性HF住院的患者中,未观察到神经激素效应和临床结局的显著差异。