| Abstract | BACKGROUND: The aim of this study was to evaluate the effects of carvedilol therapy on left atrial (LA) function in patients with heart failure from nonischemic dilated cardiomyopathy. METHODS AND RESULTS: Thirty-five patients (42.4 +/- 13.5 years) in New York Heart Association functional Class II-III have been studied. A low-dose (20 mug.kg.min) echo-dobutamine study has been performed, before and 12 months after carvedilol therapy. Twelve months after carvedilol therapy, a significant improvement in LA and left ventricular (LV) function was observed. To investigate the beneficial effects of carvedilol, patients were separated into 2 groups according to the presence of pretreatment LV contractile reserve (CR) (ejection fraction [EF] increases >20% after dobutamine infusion): Group A consisted of 18 patients with CR and Group B of 17 patients without CR. After carvedilol treatment, both the LV and LA function were improved in group A (P < .01 for all). However, in group B, only the LA function was significantly improved (left atrial ejection volume increased from 10.4 +/- 3 mL to 15.4 +/- 6.7, P < .01 and LA ejection fraction from 19.6 +/- 45.3% to 29.4 +/- 12.5%, P < .01), whereas the LV contractile reserve has partially reappeared (EF from 29.9 +/- 4.5% at baseline, increased after dobutamine infusion to 35.8 +/- 6.8%, P < .0001). CONCLUSIONS: In conclusion, carvedilol therapy is associated with improvement in both LV and LA functions in nonischemic dilated cardiomyopathy. In a subgroup of these patients, carvedilol may act differently on LV and LA function. |
| Authors | Ioannis Paraskevaidis, Dimitrios Farmakis, John T Parissis, Thomas Dodouras, Gerasimos Filippatos, Dimitrios Tsiapras, Dimitrios Th Kremastinos
(Affiliation: Second Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.)
|
| Journal | Journal of cardiac failure
(J Card Fail)
Vol. 13
Issue 2
Pg. 108-13
(Mar 2007)
ISSN: 1532-8414 United States |
| PMID | 17395050
(Publication Type: Journal Article)
|
| Chemical References |
- Adrenergic beta-Antagonists
- Carbazoles
- Cardiotonic Agents
- Propanolamines
- Dobutamine
- carvedilol
|
| Topics |
- Adrenergic beta-Antagonists
(therapeutic use)
- Adult
- Atrial Function, Left
(drug effects, physiology)
- Carbazoles
(therapeutic use)
- Cardiomyopathy, Dilated
(complications, drug therapy, physiopathology)
- Cardiotonic Agents
(administration & dosage, diagnostic use)
- Dobutamine
(administration & dosage, diagnostic use)
- Echocardiography, Doppler
- Echocardiography, Stress
- Female
- Follow-Up Studies
- Heart Atria
(drug effects, physiopathology, ultrasonography)
- Heart Ventricles
(drug effects, physiopathology, ultrasonography)
- Humans
- Infusions, Intravenous
- Male
- Middle Aged
- Propanolamines
(therapeutic use)
- Stroke Volume
(drug effects, physiology)
- Time Factors
- Treatment Outcome
- Ventricular Dysfunction, Left
(drug therapy, etiology, physiopathology)
- Ventricular Function, Left
(drug effects, physiology)
|
