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Long-term
Carvedilol Treatment for Severe Heart Failure in Patients |
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Sh. D.
Chumburidze |
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The
aim
of the study was to assess long-term efficacy of carvedilol (Dilatrend) in
patients (pts) with dilated cardiomyopathy complicated with congestive
heart failure. Methods
22 pts with NYHA III to IV heart failure
(14 men, 8 women, aged 32±4
years and LV ejection fraction <40%) assigned to treatment with
carvedilol (n=11) or placebo (n=11) in a double – blind randomized
fashion. Background
therapy consisted of ACE inhibitors, diuretics, digoxin and
anticoagulants. Duration of the study was 6 months. Results.
After 6 months of treatment there were significant deference’s among
hemodynamyc variables. At rest, cardiac output improved in the carvedilol
group (from 4,0 to 4,7) but decreased in the placebo group (from 5,3 to
4,9) (p=0,02). Peak exercise heart rate decreased more in the carvedilol
group then in the placebo group (p=0,0003). Carvedilol therapy resulted in
a significant improvement in LV ejection fraction from 0,19 to 0,25 after
6 months of therapy. LV ejection fraction remained unchanged in placebo
group (0,19-0,20) during the same period (p<0,001) In
the carvedilol group treadmill time increased from 430 to 515 second
(p=0,04) 6 minute walk from 1,234 to 1,567 (feet) (p=0,02) In
the placebo group the corresponding changes were: from 482 to 496 (p=NS)
and from 1,129 to 1,163 (p=NS). Minnesota
Living With Heart Failure Questionnaire score improved from 66 to 38
(p=0,0001) In the placebo group from 59 to 53 (p=NS). |
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