       Document 1046
 DOCN  M9621046
 TI    A management trial for Duchenne cardiomyopathy.
 DT    9602
 AU    Ishikawa Y; Bach JR; Ishikawa Y; Minami R; Department of Pediatrics,
       Sapporo University of Medicine,; Hokkaido, Japan.
 SO    Am J Phys Med Rehabil. 1995 Sep-Oct;74(5):345-50. Unique Identifier :
       AIDSLINE MED/96036557
 AB    The physiatrist can now be instrumental in prolonging the survival of
       individuals with neuromuscular disease by using respiratory muscle aids.
       As a result, morbidity and mortality from cardiomyopathy are likely to
       increase for patients with generalized myopathies. One hundred
       consecutive patients with dystrophin-deficient muscular dystrophy and a
       mean age of 17.2 yr (range, 5-41) satisfied criteria for having dilated
       cardiomyopathy (DCM) and received digitalis and diuretics. Nine of the
       14 patients were symptom-free, despite left ventricular ejection
       fractions (LVEFs) of 25-40%. The five patients with symptomatic heart
       failure had severe ventricular dilatation, with LVEFs < 25%. Two of the
       five patients died of heart failure within 1 yr. For the remaining three
       patients, we evaluated the addition of the angiotensin-converting enzyme
       (ACE) inhibitor enalapril and, subsequently, the use of beta-blockers to
       the therapeutic regimen. Addition of these medications, never before
       attempted in the management of cardiomyopathy associated with
       generalized myopathic disease, complemented each other in relieving
       symptoms and reversing signs of congestive heart failure and DCM. We
       conclude that the combination of ACE inhibitor and beta-blocker deserves
       further exploration for inclusion in any management regimen for the
       treatment of muscular dystrophy-associated cardiomyopathy.
 DE    Adolescence  Adrenergic beta-Antagonists/*THERAPEUTIC USE  Adult
       Angiotensin-Converting Enzyme Inhibitors/*THERAPEUTIC USE  Atrial
       Natriuretic Factor/BLOOD  Bisoprolol/*THERAPEUTIC USE  Cardiomyopathy,
       Congestive/*COMPLICATIONS/*DRUG THERAPY  Child  Child, Preschool
       Diuretics/THERAPEUTIC USE  Drug Administration Schedule  Drug Therapy,
       Combination  Enalapril/*THERAPEUTIC USE  Heart Failure,
       Congestive/COMPLICATIONS/DRUG THERAPY  Heart Function Tests  Human
       Muscular Dystrophy/*COMPLICATIONS  Support, Non-U.S. Gov't  CLINICAL
       TRIAL  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

