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Use of midodrine in heart failure: a review

Heart failure is a global health concern, affecting millions of individuals worldwide. Midodrine, an alpha-1 receptor agonist, might be a potential treatment option for patients with heart failure and concurrent hypotension. This review provides a comprehensive summary of the existing literature on...

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Autores principales: Gautam, Sudarshan, Lamichhane, Saral, Sharma, Nava R., KC, Prabal, Basnet, Arjun, Kansakar, Sajog, Pokhrel, Madalasa, Shetty, Vijay, Moskovits, Norbert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289700/
https://www.ncbi.nlm.nih.gov/pubmed/37363594
http://dx.doi.org/10.1097/MS9.0000000000000922
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author Gautam, Sudarshan
Lamichhane, Saral
Sharma, Nava R.
KC, Prabal
Basnet, Arjun
Kansakar, Sajog
Pokhrel, Madalasa
Shetty, Vijay
Moskovits, Norbert
author_facet Gautam, Sudarshan
Lamichhane, Saral
Sharma, Nava R.
KC, Prabal
Basnet, Arjun
Kansakar, Sajog
Pokhrel, Madalasa
Shetty, Vijay
Moskovits, Norbert
author_sort Gautam, Sudarshan
collection PubMed
description Heart failure is a global health concern, affecting millions of individuals worldwide. Midodrine, an alpha-1 receptor agonist, might be a potential treatment option for patients with heart failure and concurrent hypotension. This review provides a comprehensive summary of the existing literature on the use of midodrine in heart failure patients, focusing on its pharmacology, epidemiology, and public health impact. Guideline-directed medical therapy (GDMT) is essential in heart failure management, but hypotension may limit its initiation or up-titration. Studies have shown that midodrine can improve blood pressure, reduce the need for vasopressor support, and enable the prescription of GDMT in patients who are intolerant to it due to hypotension. However, there are concerns over increased all-cause mortality in some studies, small sample sizes, and nonrandomized study designs in others. Further research, including large-scale randomized controlled trials and long-term follow-up studies, is needed to better understand the risks and benefits of midodrine use in heart failure patients, particularly in relation to GDMT. Clinicians should consider the potential advantages of midodrine against the limited evidence and potential risks before incorporating it into their clinical practice for heart failure treatment.
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spelling pubmed-102897002023-06-24 Use of midodrine in heart failure: a review Gautam, Sudarshan Lamichhane, Saral Sharma, Nava R. KC, Prabal Basnet, Arjun Kansakar, Sajog Pokhrel, Madalasa Shetty, Vijay Moskovits, Norbert Ann Med Surg (Lond) Review Articles Heart failure is a global health concern, affecting millions of individuals worldwide. Midodrine, an alpha-1 receptor agonist, might be a potential treatment option for patients with heart failure and concurrent hypotension. This review provides a comprehensive summary of the existing literature on the use of midodrine in heart failure patients, focusing on its pharmacology, epidemiology, and public health impact. Guideline-directed medical therapy (GDMT) is essential in heart failure management, but hypotension may limit its initiation or up-titration. Studies have shown that midodrine can improve blood pressure, reduce the need for vasopressor support, and enable the prescription of GDMT in patients who are intolerant to it due to hypotension. However, there are concerns over increased all-cause mortality in some studies, small sample sizes, and nonrandomized study designs in others. Further research, including large-scale randomized controlled trials and long-term follow-up studies, is needed to better understand the risks and benefits of midodrine use in heart failure patients, particularly in relation to GDMT. Clinicians should consider the potential advantages of midodrine against the limited evidence and potential risks before incorporating it into their clinical practice for heart failure treatment. Lippincott Williams & Wilkins 2023-05-24 /pmc/articles/PMC10289700/ /pubmed/37363594 http://dx.doi.org/10.1097/MS9.0000000000000922 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 (https://creativecommons.org/licenses/by-nc-sa/4.0/) License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0/ (https://creativecommons.org/licenses/by-nc-sa/4.0/)
spellingShingle Review Articles
Gautam, Sudarshan
Lamichhane, Saral
Sharma, Nava R.
KC, Prabal
Basnet, Arjun
Kansakar, Sajog
Pokhrel, Madalasa
Shetty, Vijay
Moskovits, Norbert
Use of midodrine in heart failure: a review
title Use of midodrine in heart failure: a review
title_full Use of midodrine in heart failure: a review
title_fullStr Use of midodrine in heart failure: a review
title_full_unstemmed Use of midodrine in heart failure: a review
title_short Use of midodrine in heart failure: a review
title_sort use of midodrine in heart failure: a review
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289700/
https://www.ncbi.nlm.nih.gov/pubmed/37363594
http://dx.doi.org/10.1097/MS9.0000000000000922
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