Document Detail

Is beta-blockade useful in heart failure patients with atrial fibrillation? An analysis of data from two previously completed prospective trials.
MedLine Citation:
PMID:  12167389     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Beta-adrenergic blockade is of proven value in chronic heart failure. It is uncertain, however, if beta-blockade provides a similar degree of clinical benefit for heart failure patients with atrial fibrillation (AF) as those in sinus rhythm (SR).
AIMS: To compare the effectiveness of beta blockade in patients with heart failure and AF.
METHODS: Patients with chronic heart failure were randomized to treatment (double blind) with metoprolol 50 mg twice daily or carvedilol 25 mg twice daily in addition to standard therapy. Response was assessed after 12 weeks by a quality of life questionnaire, New York Heart Association class, exercise capacity (6-min walk test), radionucleotide ventriculography for LVEF, 2-D echocardiography measurement of left ventricular (LV) dimensions and diastolic filling and 24-h electrocardiograph monitoring to assess heart rate changes.
RESULTS: Both beta-blockers produced significant improvements in LVEF in both the SR group: (+6+/-10% at 12-week, P<0.001) and the AF group: (+11+/-9% at 12-week, P<0.05). However, significant improvement in symptoms (P<0.001) and exercise capacity (P<0.001) were observed only in the SR group but not in the AF group despite a significant improvement in LVEF.
CONCLUSION: Beta-blockers were effective in improving LV ejection fraction in chronic heart failure patients in either SR or AF but had less effect on symptoms and exercise capacity in those with AF.
Jeffrey W H Fung; Skiva K W Chan; Leata Y C Yeung; John E Sanderson
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of heart failure     Volume:  4     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-08     Completed Date:  2002-10-29     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  489-94     Citation Subset:  IM    
Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital Shatin, NT, Hong Kong, SAR, PR China.
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MeSH Terms
Adrenergic beta-Antagonists / adverse effects,  therapeutic use*
Aged, 80 and over
Atrial Fibrillation / drug therapy*,  physiopathology
Carbazoles / adverse effects,  therapeutic use*
Chronic Disease
Double-Blind Method
Heart Failure / drug therapy*,  physiopathology
Metoprolol / adverse effects,  therapeutic use*
Middle Aged
Propanolamines / adverse effects,  therapeutic use*
Prospective Studies
Stroke Volume / drug effects
Treatment Outcome
Ventricular Function, Left / drug effects
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Propanolamines; 0K47UL67F2/carvedilol; 37350-58-6/Metoprolol

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