| Comparison of the effects of carvedilol and metoprolol on exercise ventilatory efficiency in patients with congestive heart failure. | |
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MedLine Citation:
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PMID: 18296829 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Masaharu Kataoka; Toru Satoh; Tsutomu Yoshikawa; Iwao Nakamura; Takashi Kohno; Akihiro Yoshizawa; Toshihisa Anzai; Satoshi Ogawa |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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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:
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Created Date: 2008-02-25 Completed Date: 2008-07-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: Japan |
Other Details:
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Languages: eng Pagination: 358-63 Citation Subset: IM |
Affiliation:
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Cardiopulmonary Division, Department of Medicine, Keio University School of Medicine, Tokyo, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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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:
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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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