<Case Reports>New therapeutic trials for heart failure in a case with dilated cardiomyopathy

  • HIRANO Yutaka
    First Department of Internal Medicine, Kinki University School of Medicine
  • KANAMASA Ken
    First Department of Internal Medicine, Kinki University School of Medicine
  • MORISHITA Masataka
    First Department of Internal Medicine, Kinki University School of Medicine
  • SHIMIZU Minoru
    First Department of Internal Medicine, Kinki University School of Medicine
  • HAYASHI Takahiro
    First Department of Internal Medicine, Kinki University School of Medicine
  • INOKI Tatsushi
    First Department of Internal Medicine, Kinki University School of Medicine
  • ISHIKAWA Kinji
    First Department of Internal Medicine, Kinki University School of Medicine
  • KATORI Ryo
    First Department of Internal Medicine, Kinki University School of Medicine
  • TANJI Kurenai
    Second Department of Pathology, Kinki University School of Medicine
  • HASHIMOTO Shigeo
    Second Department of Pathology, Kinki University School of Medicine

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Other Title
  • <症例>拡張型心筋症の1例における各種の心不全治療法の経験

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Dilated cardiomyopathy (DCM) is characterized by the dilation of the ventricles, the decrease of contractility and refractory heart failure which lead to a very poor prognosis. We report a case of DCM who showed refractory heart failure and underwent intensive treatment for about four years. The patient was a 37 year old woman who had a marked cardiomegaly, increased left ventricular dimension, the decrease of contractility, severe global hypokinesis and normal coronary arteries. Among new catecholamine analogues, denopamine and ibopamine showed a temporary improvement of cardiac failure, especially the latter was effective to increase urine volume. Vasodilators administered as a vasodilator therapy to reduce preload such as nitroglycerin were most effective, because right heart failure was predominant in this patient. Extra corporeal ultrafiltration method (ECUM) was useful for reducing volume overload.

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