Use of Midodrine in Heart Failure: Two Case Reports and a Review of the Literature

  • Adnan Hajjiah Clinical Pharmacy Department, Ahmadi Hospital – Kuwait Oil Company, Al Ahmadi, Kuwait
  • Ossama Maadarani Internal Medicine Department, Ahmadi Hospital – Kuwait Oil Company, Al Ahmadi, Kuwait
  • Zouheir Bitar Internal Medicine Department, Ahmadi Hospital – Kuwait Oil Company, Al Ahmadi, Kuwait
  • Boutros Hanna Internal Medicine Department, Ahmadi Hospital – Kuwait Oil Company, Al Ahmadi, Kuwait
  • Ragab Elshabasy Internal Medicine Department, Ahmadi Hospital – Kuwait Oil Company, Al Ahmadi, Kuwait
  • Mohamed Abdelfatah Internal Medicine Department, Ahmadi Hospital – Kuwait Oil Company, Al Ahmadi, Kuwait
  • Mohammad Gohar Internal Medicine Department, Ahmadi Hospital – Kuwait Oil Company, Al Ahmadi, Kuwait
DOI: https://doi.org/10.12890/2022_003246

Keywords

Midodrine, heart failure, noradrenaline

Abstract

Hypotension in patients with heart failure is much more frequent in daily clinical practice than the 10–15% reported in clinical trials. In patients with heart failure with reduced ejection fraction (HFrEF), hypotension frequently limits the initiation and up-titration of guideline-directed medical therapy (GDMT). Midodrine is a peripheral alpha-1 agonist and a vasopressor anti-hypotensive agent approved for the treatment of orthostatic hypotension. We describe two cases where midodrine was prescribed in patients with HFrEF and hypotension.

VIEW THE ENTIRE ARTICLE

References

  • CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987;316:1429–1435.
  • Komajda M, Schope J, Wagenpfeil S, Tavazzi L, Bohm M, Ponikowski P, et al.; QUALIFY Investigators. Physicians’ guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Fail 2019;21:921–929.
  • Ambrosy AP, Vaduganathan M, Mentz RJ, Greene SJ, Subacius H, Konstam MA, et al. Clinical profile and prognostic value of low systolic blood pressure in patients hospitalized for heart failure with reduced ejection fraction: insights from the Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study with Tolvaptan (EVEREST) trial. Am Heart J 2013;165:216–225.
  • Tartiere JM, Logeart D, Safar ME, Cohen-Solal A. Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure. J Hum Hypertens 2006;20:213–219.
  • National Library of Medicine - PubChem. Midodrine hydrochloride. Available from https://pubchem.ncbi.nlm.nih.gov/compound/Midodrine-hydrochloride.
  • Prakash S, Garg AX, Heidenheim AP, House AA. Midodrine appears to be safe and effective for dialysis-induced hypotension: a systematic review. Nephrol Dial Transplant 2004 Oct;19(10):2553–2558. doi: 10.1093/ndt/gfh420, PMID: 15280522.
  • Brunelli SM, Cohen DE, Marlowe G, Van Wyck D. The impact of midodrine on outcomes in patients with intradialytic hypotension. Am J Nephrol 2018;48(5):381–388. doi: 10.1159/000494806, PMID: 30423552.
  • Scoma C, Dae-Hyun L, Cohen A, Fernandez J. Prevalence of midodrine use in patients admitted with systolic congestive heart. J Am Coll Cardiol 2021;77(18):678. doi: 10.1016/S0735-1097(21)02037-4.
  • Zakir RM, Folefack A, Saric M, Berkowitz RL. The use of midodrine in patients with advanced heart failure. Congest Heart Fail 2009 May-Jun;15(3):108–111. doi: 10.1111/j.1751-7133.2008.00042.x, PMID: 19522958.
  • Folefack A, Zakir RM, Saric M, Berkowitz RL. Midodrine increases blood pressure in hypotensive heart failure patients facilitating optimization of heart failure therapy leading to improved outcomes. J Cardiac Fail 2006;12<(6):S129. doi: https://doi.org/10.1016/j.cardfail.2006.06.448.
  • Vijayaraghavan K, Little D, Mercer T, Querrey T, Wilmowski S, Win A, et al. Midodrine as a bridge to enable use of life enhancing therapies in chronic heart failure. J Cardiac Fail 2020;26(10):S59. https://doi.org/10.1016/j.cardfail.2020.09.175.
  • Bergman SM. Hemodialysis in hypotensive heart failure using midodrine. Am J Med Sci 2009 Dec;338(6):470–473. doi: 10.1097/MAJ.0b013e3181b7efa7, PMID: 19875951.

    • Published: 2022-03-18

    Issue: 2022: Vol 9 No 3 (view)

    Section: Articles

    How to cite:
    1.
    Hajjiah A, Maadarani O, Bitar Z, Hanna B, Elshabasy R, Abdelfatah M, Gohar M. Use of Midodrine in Heart Failure: Two Case Reports and a Review of the Literature . EJCRIM 2022;9 doi:10.12890/2022_003246.

    Similar Articles

    You may also start an advanced similarity search for this article.

    Most read articles by the same author(s)

    1 2 > >>