Document Detail


Electrophysiological effects of carvedilol administration in patients with dilated cardiomyopathy.
MedLine Citation:
PMID:  18205033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Several studies suggest the clinical efficacy of carvedilol in reducing atrial and ventricular arrhythmias in patients with left ventricular dysfunction (LVD) due to congestive heart failure (CHF) or following myocardial infarction. However, the mechanisms supporting its antiarrhythmic efficacy have been derived from experimental studies. In this prospective, placebo-controlled trial we examined the electrophysiological effects of a high oral dose of carvedilol in patients with CHF and LVD due to non-ischemic dilated cardiomyopathy.
METHODS: Thirty-one patients with stable CHF underwent electrophysiological study and were randomly assigned to treatment with carvedilol or placebo. After 2 months of treatment the study was repeated.
RESULTS: Carvedilol prolonged almost all conduction times. In the same group atrial and ventricular effective refractory periods were significantly prolonged, while the parameters of repolarization remained virtually unchanged. The prolongation of refractoriness was most pronounced in the atrium. The change in ventricular refractoriness was correlated with ejection fraction (r = 0.94, p < 0.01) suggesting that patients with more preserved left ventricular function responded to treatment with greater prolongation.
CONCLUSION: Even after a short period of administration carvedilol has marked and diffused electrophysiological effects that would be beneficial for patients with CHF and may contribute to the positive outcome of clinical trials.
Authors:
Emmanuel M Kanoupakis; Emmanuel G Manios; Hercules E Mavrakis; Eleftherios M Kallergis; George M Lyrarakis; Emmanuel P Koutalas; Panos E Vardas
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-01-20
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  22     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-07-28     Completed Date:  2008-11-03     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  169-76     Citation Subset:  IM    
Affiliation:
Cardiology Department, Heraklion University Hospital, Heraklion, Crete, Greece.
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MeSH Terms
Descriptor/Qualifier:
Action Potentials / drug effects
Adrenergic beta-Antagonists / therapeutic use*
Aged
Blood Pressure / drug effects
Carbazoles / therapeutic use*
Cardiomyopathy, Dilated / drug therapy*,  physiopathology*
Cardiotonic Agents / therapeutic use
Death, Sudden, Cardiac / prevention & control
Electrocardiography / drug effects
Electrophysiology
Female
Humans
Male
Middle Aged
Propanolamines / therapeutic use*
Refractory Period, Electrophysiological / drug effects
Risk
Sinoatrial Node / drug effects
Stroke Volume / drug effects,  physiology
Tachycardia, Ventricular / drug therapy,  physiopathology
Ventricular Function, Left / drug effects
Ventricular Function, Right / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Cardiotonic Agents; 0/Propanolamines; 0K47UL67F2/carvedilol
Comments/Corrections
Comment In:
Cardiovasc Drugs Ther. 2008 Jun;22(3):163-4   [PMID:  18392930 ]

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


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