Effect of a Single Oral Dose of the PDE Inhibitor Milrinone on Exercise Tolerance of Chronic Heart Failure Patients — CPX in Advanced Heart Failure

Abstract

In addition to improvement of the very serious mortality prognosis of patients with severe heart failure in New York Heart Association (NYHA) classes III and IV, a priority goal of therapy is to raise the exercise tolerance increasingly restricted by progressive heart failure, as well as to relieve the agonizing dyspnea in the daily life of these patients. Every treatment concept for long-term therapy of chronic heart failure must consider these two important parameters. Nitrates and diuretics offer immediate relief of the clinical symptoms of patients with severe heart failure. The beneficial influence of ACE inhibitors on the mortality prognosis and clinical symptoms in 60–80% of patients has now been established [1–3]. Yet the prognosis remains very serious once the clinical condition of patients has reached NYHA classes III and IV [4, 5]. Even an optimal therapeutic concept including digitalis, diuretics, nitrates, and ACE inhibitors can often hardly improve the significantly reduced exercise tolerance, nor can it measurably relieve the dyspnea of these patients in the advanced stage of their chronic heart failure.