Does atrial fibrillation in elderly patients with chronic heart failure limit the efficacy of carvedilol? Suggestions from an observational study

Cristina Opasich, Stefania De Feo, Giovanni Cioffi, Giovanni Pulignano, Donatella Del Sindaco, Luigi Tarantini, Alessandra Gualco, Anna Patrignani

Research output: Contribution to journalArticle

Abstract

Background: No clinical investigation provided any information about a possible influence of atrial fibrillation on the response to beta-blocker therapy in elderly patients with chronic heart failure (CHF). The aim of this study was to observe carvedilol effects in a cohort of patients > 70 years of age with CHF due to left ventricular dysfunction and with chronic atrial fibrillation. Methods: An observational, 12-month prospective clinical and echocardiographic study was carried out on 240,patients > 70 years of age with heart failure due to systolic dysfunction, 64 of whom with atrial fibrillation. Results: After 1 year of beta-blocker treatment, patients with atrial fibrillation and those in sinus rhythm showed similar benefits, in terms of symptomatic improvement (ANYHA -0.44 if atrial fibrillation vs -0.57 if sinus rhythm, p = NS), reduction of events (death + hospitalizations -38 vs -15 %), recovery of cardiac function (left ventricular ejection fraction ±8.8 vs +9.4%, p = NS; left ventricular end-diastolic volume -17.2 vs -12.5 ml, p = NS), and reduction in mitral regurgitation (.042 vs -0.57, p = NS). No difference was found between the two study groups regarding left ventricular end-diastolic volume reduction (12% in atrial fibrillation patients and 18% in sinus rhythm patients, p = NS) and prevalence of the "reverse remodeling" phenomenon (22 anal 21%, respectively, p = NS). Conclusions: In CHF patients > 70 years of age, beta-adrenergic blockade was shown to be equally effective in improving symptoms and left ventricular geometry and function in patients with atrial fibrillation or in sinus rhythm, without any adjunctive sign of long-term clinical deterioration. (Ital Heart J 2005; 6 (4): 323-327)

Original languageEnglish
Pages (from-to)323-327
Number of pages5
JournalItalian Heart Journal
Volume6
Issue number4
Publication statusPublished - Apr 2005

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Atrial Fibrillation
Observational Studies
Heart Failure
Stroke Volume
carvedilol
Recovery of Function
Mitral Valve Insufficiency
Left Ventricular Dysfunction
Left Ventricular Function
Adrenergic Agents
Hospitalization
Therapeutics

Keywords

  • Atrial fibrillation
  • Carvedilol
  • Elderly
  • Heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Opasich, C., De Feo, S., Cioffi, G., Pulignano, G., Del Sindaco, D., Tarantini, L., ... Patrignani, A. (2005). Does atrial fibrillation in elderly patients with chronic heart failure limit the efficacy of carvedilol? Suggestions from an observational study. Italian Heart Journal, 6(4), 323-327.

Does atrial fibrillation in elderly patients with chronic heart failure limit the efficacy of carvedilol? Suggestions from an observational study. / Opasich, Cristina; De Feo, Stefania; Cioffi, Giovanni; Pulignano, Giovanni; Del Sindaco, Donatella; Tarantini, Luigi; Gualco, Alessandra; Patrignani, Anna.

In: Italian Heart Journal, Vol. 6, No. 4, 04.2005, p. 323-327.

Research output: Contribution to journalArticle

Opasich, C, De Feo, S, Cioffi, G, Pulignano, G, Del Sindaco, D, Tarantini, L, Gualco, A & Patrignani, A 2005, 'Does atrial fibrillation in elderly patients with chronic heart failure limit the efficacy of carvedilol? Suggestions from an observational study', Italian Heart Journal, vol. 6, no. 4, pp. 323-327.
Opasich, Cristina ; De Feo, Stefania ; Cioffi, Giovanni ; Pulignano, Giovanni ; Del Sindaco, Donatella ; Tarantini, Luigi ; Gualco, Alessandra ; Patrignani, Anna. / Does atrial fibrillation in elderly patients with chronic heart failure limit the efficacy of carvedilol? Suggestions from an observational study. In: Italian Heart Journal. 2005 ; Vol. 6, No. 4. pp. 323-327.
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abstract = "Background: No clinical investigation provided any information about a possible influence of atrial fibrillation on the response to beta-blocker therapy in elderly patients with chronic heart failure (CHF). The aim of this study was to observe carvedilol effects in a cohort of patients > 70 years of age with CHF due to left ventricular dysfunction and with chronic atrial fibrillation. Methods: An observational, 12-month prospective clinical and echocardiographic study was carried out on 240,patients > 70 years of age with heart failure due to systolic dysfunction, 64 of whom with atrial fibrillation. Results: After 1 year of beta-blocker treatment, patients with atrial fibrillation and those in sinus rhythm showed similar benefits, in terms of symptomatic improvement (ANYHA -0.44 if atrial fibrillation vs -0.57 if sinus rhythm, p = NS), reduction of events (death + hospitalizations -38 vs -15 {\%}), recovery of cardiac function (left ventricular ejection fraction ±8.8 vs +9.4{\%}, p = NS; left ventricular end-diastolic volume -17.2 vs -12.5 ml, p = NS), and reduction in mitral regurgitation (.042 vs -0.57, p = NS). No difference was found between the two study groups regarding left ventricular end-diastolic volume reduction (12{\%} in atrial fibrillation patients and 18{\%} in sinus rhythm patients, p = NS) and prevalence of the {"}reverse remodeling{"} phenomenon (22 anal 21{\%}, respectively, p = NS). Conclusions: In CHF patients > 70 years of age, beta-adrenergic blockade was shown to be equally effective in improving symptoms and left ventricular geometry and function in patients with atrial fibrillation or in sinus rhythm, without any adjunctive sign of long-term clinical deterioration. (Ital Heart J 2005; 6 (4): 323-327)",
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AU - Pulignano, Giovanni

AU - Del Sindaco, Donatella

AU - Tarantini, Luigi

AU - Gualco, Alessandra

AU - Patrignani, Anna

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N2 - Background: No clinical investigation provided any information about a possible influence of atrial fibrillation on the response to beta-blocker therapy in elderly patients with chronic heart failure (CHF). The aim of this study was to observe carvedilol effects in a cohort of patients > 70 years of age with CHF due to left ventricular dysfunction and with chronic atrial fibrillation. Methods: An observational, 12-month prospective clinical and echocardiographic study was carried out on 240,patients > 70 years of age with heart failure due to systolic dysfunction, 64 of whom with atrial fibrillation. Results: After 1 year of beta-blocker treatment, patients with atrial fibrillation and those in sinus rhythm showed similar benefits, in terms of symptomatic improvement (ANYHA -0.44 if atrial fibrillation vs -0.57 if sinus rhythm, p = NS), reduction of events (death + hospitalizations -38 vs -15 %), recovery of cardiac function (left ventricular ejection fraction ±8.8 vs +9.4%, p = NS; left ventricular end-diastolic volume -17.2 vs -12.5 ml, p = NS), and reduction in mitral regurgitation (.042 vs -0.57, p = NS). No difference was found between the two study groups regarding left ventricular end-diastolic volume reduction (12% in atrial fibrillation patients and 18% in sinus rhythm patients, p = NS) and prevalence of the "reverse remodeling" phenomenon (22 anal 21%, respectively, p = NS). Conclusions: In CHF patients > 70 years of age, beta-adrenergic blockade was shown to be equally effective in improving symptoms and left ventricular geometry and function in patients with atrial fibrillation or in sinus rhythm, without any adjunctive sign of long-term clinical deterioration. (Ital Heart J 2005; 6 (4): 323-327)

AB - Background: No clinical investigation provided any information about a possible influence of atrial fibrillation on the response to beta-blocker therapy in elderly patients with chronic heart failure (CHF). The aim of this study was to observe carvedilol effects in a cohort of patients > 70 years of age with CHF due to left ventricular dysfunction and with chronic atrial fibrillation. Methods: An observational, 12-month prospective clinical and echocardiographic study was carried out on 240,patients > 70 years of age with heart failure due to systolic dysfunction, 64 of whom with atrial fibrillation. Results: After 1 year of beta-blocker treatment, patients with atrial fibrillation and those in sinus rhythm showed similar benefits, in terms of symptomatic improvement (ANYHA -0.44 if atrial fibrillation vs -0.57 if sinus rhythm, p = NS), reduction of events (death + hospitalizations -38 vs -15 %), recovery of cardiac function (left ventricular ejection fraction ±8.8 vs +9.4%, p = NS; left ventricular end-diastolic volume -17.2 vs -12.5 ml, p = NS), and reduction in mitral regurgitation (.042 vs -0.57, p = NS). No difference was found between the two study groups regarding left ventricular end-diastolic volume reduction (12% in atrial fibrillation patients and 18% in sinus rhythm patients, p = NS) and prevalence of the "reverse remodeling" phenomenon (22 anal 21%, respectively, p = NS). Conclusions: In CHF patients > 70 years of age, beta-adrenergic blockade was shown to be equally effective in improving symptoms and left ventricular geometry and function in patients with atrial fibrillation or in sinus rhythm, without any adjunctive sign of long-term clinical deterioration. (Ital Heart J 2005; 6 (4): 323-327)

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