Investigating the effect of short-term pulse with “low dose” of inotropic drugs on the quality of life of advanced heart failure patients with class III function and symptoms of low cardiac output

Abstract

Over time, advanced heart failure (AHF) and its complications cause limitations in the normal life process and decrease the quality of life (QOL), and its negative effects on social, family and work aspects increase the risk of re-hospitalization and mortality. In these patients, inotropic drugs are used to relieve symptoms. According to the limited results about the effect of inotropic treatments on the QOL of patients with HF, especially AHF, and also the lack of sufficient study of this issue in the country, the effect of inotropic drugs (milrinone or norepinephrine) on the QOL of patients with AHF with function class III and symptoms of low cardiac output were investigated. Materials and Methods: In this study, all patients who were diagnosed with AHF in the first 6 months of 1402 to Shahid Madani Hospital were included in the study. Candidate patients were hospitalized according to guidelines and received inotropes according to the 24-hour protocol. QOL was assessed at the beginning of the study and two weeks after the last inotrope administration using the Minnesota and SF-36 questionnaires. Results: Renal factors including BUN, Cr and UA as well as liver factors including AST, ALT, ALKP and direct and total bilirubin were significantly decreased after treatment with inotropes, milrinone and norepinephrine. In examining the QOL by the Minnesota Questionnaire, in both physical and emotional dimensions as well as the overall QOL, the scores decreased by 12, 11.53 and 26.42, respectively, which indicates the improvement after treatment with inotropes. The results of the SF-36 questionnaire also confirmed the improvement of QOL and showed an increase in scores in both physical and mental dimensions by 47 and 14.88, respectively.