Document Detail


Comparison of the effects of carvedilol and metoprolol on exercise ventilatory efficiency in patients with congestive heart failure.
MedLine Citation:
PMID:  18296829     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The slope of the relationship between ventilation and carbon dioxide production (VE/VCO2 slope), obtained during symptom-limited ramp exercise testing, reflects exercise ventilatory efficiency. Importantly, the VE/VCO2 slope is related to prognosis in patients with congestive heart failure (CHF). The aim of the present study was to determine the relationship between the institution of beta-blockers, carvedilol or metoprolol, and the VE/VCO2 slope during exercise in patients with CHF. METHODS AND RESULTS: Fifty-seven patients with New York Heart Association functional class II or III with a radionuclide left ventricular ejection fraction (LVEF) of less than 40% received carvedilol or metoprolol in a randomized fashion. The VE/VCO2 slope, LVEF and plasma brain natriuretic peptide (BNP) concentration were determined before and after 16 weeks of treatment. LVEF improved (p<0.01), but the VE/VCO2 slope and BNP did not. A significant improvement in the VE/VCO2 slope was observed in patients with LVEF <29% or BNP >63 pg/ml (respective baseline median values) (p<0.05, p<0.05). In patients with BNP >63 pg/ml, the improvement effect on the VE/VCO2 slope with carvedilol was significantly greater than that with metoprolol (p<0.05) and a significant improvement in the VE/VCO2 slope was observed only in those who took carvedilol (p<0.01). CONCLUSIONS: The VE/VCO2 slope was not improved after beta-blocker therapy in any of the patients. However, it did improve in patients with a lower LVEF or higher BNP level at baseline, and carvedilol was more effective than metoprolol in improving the VE/VCO2 slope in patients with higher BNP levels at baseline.
Authors:
Masaharu Kataoka; Toru Satoh; Tsutomu Yoshikawa; Iwao Nakamura; Takashi Kohno; Akihiro Yoshizawa; Toshihisa Anzai; Satoshi Ogawa
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  72     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-25     Completed Date:  2008-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  358-63     Citation Subset:  IM    
Affiliation:
Cardiopulmonary Division, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / pharmacology*,  therapeutic use
Aged
Blood Pressure / physiology
Carbazoles / pharmacology*,  therapeutic use
Carbon Dioxide / metabolism*
Dose-Response Relationship, Drug
Exercise / physiology*
Female
Heart Failure / drug therapy,  metabolism,  physiopathology*
Humans
Male
Metoprolol / pharmacology*,  therapeutic use
Middle Aged
Natriuretic Peptide, Brain / blood
Oxygen Consumption / physiology
Prognosis
Propanolamines / pharmacology*,  therapeutic use
Pulmonary Ventilation / drug effects*,  physiology
Stroke Volume / physiology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Propanolamines; 114471-18-0/Natriuretic Peptide, Brain; 124-38-9/Carbon Dioxide; 37350-58-6/Metoprolol; 72956-09-3/carvedilol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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