Document Detail


Efficacy of carvedilol treatment on cardiac function and cardiac sympathetic nerve activity in patients with dilated cardiomyopathy: comparison with metoprolol therapy.
MedLine Citation:
PMID:  14530474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
METHODS: We compared 15 patients with dilated cardiomyopathy (DCM) who were receiving carvedilol (group A) with 15 patients with DCM who were receiving metoprolol (group B). Before and after 1 y of treatment, cardiac (123)I-metaiodobenzylguanidine ((123)I-MIBG) uptake was assessed using the total defect score (TDS) and the heart-to-mediastinum (H/M) activity ratio from the delayed images. The New York Heart Association (NYHA) class and echocardiographic left ventricular ejection fraction (LVEF) also were assessed.
RESULTS: In both groups, the TDS decreased (in group A, from 25 +/- 14 to 16 +/- 14, P < 0.01; in group B, from 27 +/- 9 to 19 +/- 10, P < 0.01), the H/M increased (in group A, from 1.67 +/- 0.31 to 2.01 +/- 0.36, P < 0.01; in group B, from 1.68 +/- 0.21 to 1.93 +/- 0.32, P < 0.01), the LVEF increased (in group A, from 31% +/- 10% to 48% +/- 10%, P < 0.01; in group B, from 28% +/- 9% to 47% +/- 15%, P < 0.01), and the NYHA functional class improved (in group A, from 2.9 +/- 0.3 to 1.7 +/- 0.5, P < 0.01; in group B, from 2.8 +/- 0.6 to 1.7 +/- 0.6, P < 0.01). The change in LVEF was mildly correlated with the change in the TDS in group A (r = 0.41) as well as in group B (r = 0.53). In the patients with a favorable response in the TDS or H/M, the NYHA class improved more than in the patients without a favorable response (P < 0.05).
CONCLUSION: Carvedilol treatment can improve cardiac function, symptoms, and cardiac sympathetic nerve activity in patients with DCM to a similar extent as metoprolol treatment. The improvement of cardiac function and symptoms is related to the improvement of cardiac sympathetic nerve activity.
Authors:
Takuji Toyama; Hiroshi Hoshizaki; Ryotaro Seki; Naoki Isobe; Hitoshi Adachi; Shigeto Naito; Shigeru Oshima; Koichi Taniguchi
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  44     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-07     Completed Date:  2003-12-22     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1604-11     Citation Subset:  IM    
Affiliation:
Gunma Prefectural Cardiovascular Center, Maebashi, Japan. toyama.t@cvc.pref.gunma.jp
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use
Adrenergic Antagonists / administration & dosage
Adult
Aged
Carbazoles / administration & dosage*
Cardiomyopathy, Dilated / complications,  drug therapy*,  radionuclide imaging*
Female
Heart Ventricles / drug effects,  innervation,  radionuclide imaging
Humans
Male
Metoprolol / administration & dosage
Middle Aged
Propanolamines / administration & dosage*
Radiopharmaceuticals / diagnostic use
Sympathetic Nervous System / drug effects*,  radionuclide imaging*
Technetium Tc 99m Sestamibi / diagnostic use
Treatment Outcome
Ventricular Dysfunction, Left / drug therapy*,  etiology,  radionuclide imaging*
Chemical
Reg. No./Substance:
0/Adrenergic Antagonists; 0/Carbazoles; 0/Propanolamines; 0/Radiopharmaceuticals; 0K47UL67F2/carvedilol; 109581-73-9/Technetium Tc 99m Sestamibi; 37350-58-6/Metoprolol; 77679-27-7/3-Iodobenzylguanidine

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