P1-1 - Outpatient Carpertide Infusion Therapy for a Patient With Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Syndrome (MELAS)

Abstract

A case was a 46 year-old woman. She had short stature, juvenile diabetes, hearing loss, LV hypertrophy and diagnosed as MELAS at age of 39 year-old. Echocardiography showed LVDd of 51 mm; LVDs of 39 mm; IVST of 14 mm; LVPWT of 14 mm; EF of 31%. Despites oral administration of furosemide 40 mg, tolvaptan 3.75 mg, eplerenone 25 mg, perindopril 2 mg, carvedilol 3.75 mg, pimobendan 2.5 mg, she repeated hospitalization for heart failure 5–6 times a year. Since carperitide was very useful as inpatient treatment, we tried intermittent carperitide infusion therapy (starting with 0.033γ and increasing to 0.1γ every 30 minutes; 4 hours administration) in outpatient setting every 1 or 2 weeks. After 4 hours infusion therapy, lung congestion was disappeared and also indicators of transmitral flow pattern and tricuspid regurgitation pressure gradient were improved. The introduction of this therapy reduced hospitalization once in six months. In addition, total healthcare costs per 6 months decreased to less than half. Conclusion: Intermittent carperitide infusion therapy for a patient with MELAS in outpatient setting reduced hospitalization and total healthcare costs.