CARDIOVASCULAR MEDICINE Relation between heart rate, heart rhythm, and reverse left ventricular remodelling in response to carvedilol in patients with chronic heart failure: a single centre, observational study
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چکیده
Objective: To determine whether the process of reverse left ventricular remodelling in response to carvedilol is dependent on baseline heart rate (BHR), heart rhythm, or heart rate reduction (HRR) in response to carvedilol. Design: Retrospective analysis of serial echocardiograms in 257 patients with chronic systolic heart failure at baseline and at 12–18 months after starting carvedilol. Reverse left ventricular remodelling was determined by changes in left ventricular end diastolic dimension (LVEDD), end systolic dimension (LVESD), and fractional shortening (LVFS). Setting: Heart failure clinic within a university teaching hospital. Main outcome measures: Changes in LVEDD, LVESD, and LVFS. Results: LVEDD and LVESD decreased by 2.6 (0.4) mm and 4.9 (0.5) mm, respectively (mean (SEM)), and LVFS increased by 4.3 (0.5)% (all p < 0.0001 v baseline). Simple regression revealed no significant relation between BHR or HRR and the changes in LVEDD, LVESD, or LVFS. Stratification of patients into high and low BHR groups (above and below the mean) or according to the baseline heart rhythm (sinus rhythm v atrial fibrillation) showed no differences between groups in the extent of reverse left ventricular remodelling. Improvements in left ventricular function and dimensions were associated with significant improvements in New York Heart Association functional class. Conclusions: The benefits of carvedilol in terms of reverse left ventricular remodelling and symptomatic improvement in patients with chronic heart failure are independent of BHR, heart rhythm, and the HRR that occurs in response to carvedilol.
منابع مشابه
Relation between heart rate, heart rhythm, and reverse left ventricular remodelling in response to carvedilol in patients with chronic heart failure: a single centre, observational study.
OBJECTIVE To determine whether the process of reverse left ventricular remodelling in response to carvedilol is dependent on baseline heart rate (BHR), heart rhythm, or heart rate reduction (HRR) in response to carvedilol. DESIGN Retrospective analysis of serial echocardiograms in 257 patients with chronic systolic heart failure at baseline and at 12-18 months after starting carvedilol. Rever...
متن کاملCARDIOVASCULAR MEDICINE Effects of carvedilol on left ventricular remodelling in chronic stable heart failure: a cardiovascular magnetic resonance study
Background: The ability of b blockers to improve left ventricular function has been demonstrated, but data on the effects on cardiac remodelling are limited. Objective: To investigate, using cardiovascular magnetic resonance (CMR), the effects of carvedilol on left ventricular remodelling in patients with chronic stable heart failure and left ventricular systolic dysfunction caused by coronary ...
متن کاملEffects of carvedilol on left ventricular remodelling in chronic stable heart failure: a cardiovascular magnetic resonance study.
BACKGROUND The ability of beta blockers to improve left ventricular function has been demonstrated, but data on the effects on cardiac remodelling are limited. OBJECTIVE To investigate, using cardiovascular magnetic resonance (CMR), the effects of carvedilol on left ventricular remodelling in patients with chronic stable heart failure and left ventricular systolic dysfunction caused by corona...
متن کاملمقایسه متوپرولول و کارودیلول در درمان بیماران با نارسایی قلبی
Background and Aim: Heart failure is one of the most prevalent diseases with high mortality and disability. Beta blockers are among basic drugs treating the disorder and leading to reduction in cardiovascular mortality, and improvement of symptoms and left ventricular function. Regarding the increasing prevalence of this disease, the present study was carried out to compare carvedilol with meto...
متن کاملBackground & Objective : Heart failure is a clinical syndrome and increases in rate by aging. Because changes in ECG and electrolytes are variable, specific and sometimes independent to the disease with different methods to be diagnosed, in this study we tried to find a way to diagnose them. Materials & Methods: This is a retrospective descriptive-analytic study. Data was collected from dec...
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