β-Blockade therapy in chronic heart failure: Diastolic function and mitral regurgitation improvement by carvedilol

Soccorso Capomolla, Oreste Febo, Marco Gnemmi, Giorgio Riccardi, Cristina Opasich, Angelo Caporotondi, Andrea Mortara, GianDomenico Pinna, Franco Cobelli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In patients with chronic heart failure, the use of carvedilol therapy induces clinical and hemodynamic improvement. However, although the benefits of this β-blocker have been established in patients with chronic heart failure, the mechanisms underlying them and the changes in left ventricular systolic function, diastolic function, and mitral regurgitation during long-term therapy remain unclear. Objective: To identify the clinical and functional effects of carvedilol, focusing on diastolic function and mitral regurgitation variations. Methods: Forty-five consecutive patients with chronic heart failure (ejection fraction 24% ± 7%), 17 with dilated ischemic and 28 with nonischemic cardiomyopathy, were treated with carvedilol (mean dose 44 ± 30 mg) and matched for clinical (New York Heart Association functional class and heart failure duration) and hemodynamic (cardiac index and pulmonary wedge pressure) characteristics to a control group. Clinical and echocardiographic variables were measured in the 2 groups at baseline and after 6 months and the results compared. Results: After 6 months of treatment with carvedilol, left ventricular ejection fraction had increased from 24% ± 7% to 29% ± 9% (P <.0001); this change was caused by a reduction in end-systolic volume index (106 ± 41 vs 93 ± 37 mL/m2; P <.0001). Deceleration time of early diastolic filling increased (134 ± 74 vs 196 ± 63 ms; P

Original languageEnglish
Pages (from-to)596-608
Number of pages13
JournalAmerican Heart Journal
Volume139
Issue number4
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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