Normalization of Left Ventricular Parameters Following Combined Pimobendan and Carvedilol Treatment in a Case of Unclassified Cardiomyopathy with Longstanding Refractory Status

• Published in: Internal Medicine Vol. 41; no. 12; pp. 1147 - 1152
• Main Authors: TAKEDA, Norifumi, OHTAKI, Eiji, MISU, Kazuhiko, ASANO, Ryuta, TOBARU, Tetsuya, NAGAYAMA, Masatoshi, KITAHARA, Koichi, UMEMURA, Jun, SUMIYOSHI, Tetsuya, HOSODA, Saichi
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.12.2002; Japanese Society of Internal Medicine
• Subjects: Biological and medical sciences; Carbazoles - therapeutic use; Cardiology. Vascular system; Cardiomyopathies - complications; Cardiomyopathies - drug therapy; Cardiomyopathies - physiopathology; Cardiovascular Agents - therapeutic use; Cardiovascular system; Carvedilol; Heart; Heart Failure - drug therapy; Heart Failure - etiology; Heart Failure - physiopathology; Humans; interleukin-6; Male; Medical sciences; Middle Aged; Miscellaneous; myocarditis; Myocarditis. Cardiomyopathies; Pharmacology. Drug treatments; Propanolamines - therapeutic use; Pyridazines - therapeutic use; reverse remodeling; Stroke Volume - drug effects; Treatment Outcome; Ventricular Function, Left - drug effects; Cardiotonic agent; Vasodilator agent; Cardiomyopathy; α1-Adrenergic receptor; Cardiovascular disease; β2-Adrenergic receptor; Myocardial disease; interleukin-6; Alpha blocking agent; β1-Adrenergic receptor; Heart disease; Pimobendan; Complication; Antagonist; Human; Heart failure; Drug combination; Treatment efficiency; myocarditis; reverse remodeling; Left ventricle; Case study; Chemotherapy; Carvedilol; Antihypertensive agent; Beta blocking agent
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.41.1147

A 58-year-old man with a 64-month history of unclassified cardiomyopathy developed congestive heart failure (CHF) and had been dependent on long-term intravenous positive inotropes. Combined pimobendan and carvedilol administration resulted in marked symptomatic improvement from New York Heart Association functional class IV to I. Echocardiograms showed improvement of left ventricular (LV) ejection fraction from 15 to 48%, and LV enddiastolic diameter from 6.7 to 4.9 cm. This mode of therapy not only improved LV contractile function but also normalized LV volume, which was an unusual clinical course compared with the general course of advanced CHF. (Internal Medicine 41: 1147-1152, 2002)