| Efficacy of carvedilol treatment on cardiac function and cardiac sympathetic nerve activity in patients with dilated cardiomyopathy: comparison with metoprolol therapy. | |
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MedLine Citation:
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PMID: 14530474 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Carvedilol and metoprolol have been reported to be effective in the treatment of patients with chronic heart failure. However, to our knowledge, there have been no studies comparing the effects of the 2 drugs on cardiac function, including cardiac sympathetic nerve activity. 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. |
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Authors:
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Takuji Toyama; Hiroshi Hoshizaki; Ryotaro Seki; Naoki Isobe; Hitoshi Adachi; Shigeto Naito; Shigeru Oshima; Koichi Taniguchi |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article |
Journal Detail:
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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:
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Created Date: 2003-10-07 Completed Date: 2003-12-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 1604-11 Citation Subset: IM |
Affiliation:
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Gunma Prefectural Cardiovascular Center, Maebashi, Japan. toyama.t@cvc.pref.gunma.jp |
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| MeSH Terms | |
Descriptor/Qualifier:
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3-Iodobenzylguanidine
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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:
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0/Adrenergic Antagonists; 0/Carbazoles; 0/Propanolamines; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 37350-58-6/Metoprolol; 72956-09-3/carvedilol; 77679-27-7/3-Iodobenzylguanidine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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