Document Detail


Effects of long-term treatment with carvedilol on myocardial blood flow in idiopathic dilated cardiomyopathy.
MedLine Citation:
PMID:  17237134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess whether chronic treatment with carvedilol can increase myocardial blood flow (MBF) and MBF reserve in idiopathic dilated cardiomyopathy (IDC).
STUDY DESIGN: In a double-blind, placebo-controlled trial, 16 consecutive patients with IDC were randomised to treatment with either carvedilol up to 25 mg twice a day (n = 8, 7 men, mean (SD) age 60 (9) years, mean (SD) left ventricular ejection fraction (LVEF) 30% (5%)), or placebo (n = 8, 6 men, mean (SD) age 62 (9) years, mean (SD) LVEF 28% (6%), NS vs carvedilol group). Before and 6 months after treatment, regional MBF was measured at rest and after intravenous injection of dipyridamole (Dip; 0.56 mg/kg in 4 min) by positron emission tomography and using (13)N-ammonia as a flow tracer. Exercise capacity was assessed as the time duration in a maximal bicycle exercise stress test.
RESULTS: Carvedilol induced a significant decrease in heart rate at rest and during maximal exercise, and an increase in exercise capacity. Absolute MBF values did not significantly change after carvedilol or placebo treatment, either at rest or during Dip injection, although Dip-MBF tended to improve after treatment. Coronary flow reserve significantly increased following carvedilol treatment (from 1.67 (0.63) to 2.58 (1.04), p<0.001), whereas it remained unchanged following the placebo treatment (from 1.80 (0.84) to 1.77 (0.60), NS). Stress-induced regional perfusion defects decreased after carvedilol treatment (from 38% to 15%).
CONCLUSIONS: Long-term treatment with carvedilol can significantly increase coronary flow reserve and reduce the occurrence of stress-induced perfusion defects, suggesting a favourable effect of the drug on coronary microvascular function in patients with IDC.
Authors:
Danilo Neglia; Renata De Maria; Stefano Masi; Michela Gallopin; Patrizia Pisani; Silvia Pardini; Antonello Gavazzi; Antonio L'abbate; Oberdan Parodi
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-01-19
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  93     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-15     Completed Date:  2007-07-20     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  808-13     Citation Subset:  AIM; IM    
Affiliation:
CNR Institute of Clinical Physiology, Pisa, Italy. dneglia@ifc.cnr.it
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MeSH Terms
Descriptor/Qualifier:
Carbazoles / therapeutic use*
Cardiomyopathy, Dilated / drug therapy*,  physiopathology
Coronary Circulation / drug effects*
Double-Blind Method
Female
Humans
Male
Middle Aged
Positron-Emission Tomography
Propanolamines / therapeutic use*
Vasodilator Agents / therapeutic use*
Ventricular Dysfunction, Left / physiopathology
Chemical
Reg. No./Substance:
0/Carbazoles; 0/Propanolamines; 0/Vasodilator Agents; 0K47UL67F2/carvedilol
Comments/Corrections

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