Carvedilol improves left atrial and left ventricular function and reserve in dilated cardiomyopathy after 1 year of treatment.

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
• Journal: Journal of cardiac failure (J Card Fail) Vol. 13 Issue 2 Pg. 108-13 (Mar 2007) ISSN: 1532-8414 [Electronic] United States
• PMID: 17395050 (Publication Type: Journal Article)

Chemical References

• Adrenergic beta-Antagonists
• Carbazoles
• Cardiotonic Agents
• Propanolamines
• Carvedilol
• Dobutamine

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)
• Carvedilol
• Dobutamine (administration & dosage)
• Echocardiography, Doppler
• Echocardiography, Stress
• Female
• Follow-Up Studies
• Heart Atria (diagnostic imaging, drug effects, physiopathology)
• Heart Ventricles (diagnostic imaging, drug effects, physiopathology)
• 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)