Adverse mortality effect of central sympathetic inhibition with sustained‐release moxonidine in patients with heart failure (MOXCON)

@article{Cohn2003AdverseME,
  title={Adverse mortality effect of central sympathetic inhibition with sustained‐release moxonidine in patients with heart failure (MOXCON)},
  author={Jay Norman Cohn and Marc A. Pfeffer and Jean L. Rouleau and Norman Sharpe and Karl Swedberg and Matthias Straub and Curtis G. Wiltse and Theressa J. Wright},
  journal={European Journal of Heart Failure},
  year={2003},
  volume={5}
}
Case 19: Data Monitoring Experience in the Moxonidine Congestive Heart Failure Trial
The MOXonidine CONgestive Heart Failure Trial was a randomized placebo-controlled trial designed to evaluate reliably the effects of moxonidine, a central sympathetic inhibitor, on mortality and
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In this issue of the Journal, Esler et al. [1] present a remarkable study on the neurohumoral effects of the sympatholytic agent rilmenidine in hypertensive patients. The authors have treated
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References

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Effects of Sustained-Release Moxonidine, an Imidazoline Agonist, on Plasma Norepinephrine in Patients With Chronic Heart Failure
TLDR
Plasma norepinephrine was markedly reduced in a dose-related manner by moxonidine SR, accompanied by evidence of reverse remodeling, but also by an increase in adverse events.
Effect of vasodilator therapy on mortality in chronic congestive heart failure. Results of a Veterans Administration Cooperative Study.
TLDR
The data suggest that the addition of hydralazine and isosorbide dinitrate to the therapeutic regimen of digoxin and diuretics in patients with chronic congestive heart failure can have a favorable effect on left ventricular function and mortality.
Effect of carvedilol on survival in severe chronic heart failure.
Suppressing sympathetic activation in congestive heart failure. A new therapeutic strategy.
TLDR
Sympathetic suppression with clonidine in congestive heart failure reduces preload, heart rate, and arterial pressure, all indexes of myocardial energy demand; the lack of significant reduction in systemic vascular resistance and increase in cardiac output might be attributable in part to enhanced release of vasopressin.
Acute and Short-Term Effects of Clonidine in Heart Failure
TLDR
Resting of the heart by decreasing heart rate, systemic arterial blood pressure, and venous tone are thought by the authors to be major contributing factors to the observed beneficial effect of chronic oral clonidine in chronic heart failure.
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