HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Toyama, T. Articles by Taniguchi, K. Search for Related Content PubMed PubMed Citation Articles by Toyama, T. Articles by Taniguchi, K.

Efficacy of Carvedilol Treatment on Cardiac Function and Cardiac Sympathetic Nerve Activity in Patients with Dilated Cardiomyopathy: Comparison with Metoprolol Therapy

Gunma Prefectural Cardiovascular Center, Maebashi, Japan

Carvedilol and metoprolol have been reported to be effective in the treatment of patients with chronic heart failure. However, to our knowledge, there have been no studies comparing the effects of the 2 drugs on cardiac function, including cardiac sympathetic nerve activity. Methods: We compared 15 patients with dilated cardiomyopathy (DCM) who were receiving carvedilol (group A) with 15 patients with DCM who were receiving metoprolol (group B). Before and after 1 y of treatment, cardiac ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG) uptake was assessed using the total defect score (TDS) and the heart-to-mediastinum (H/M) activity ratio from the delayed images. The New York Heart Association (NYHA) class and echocardiographic left ventricular ejection fraction (LVEF) also were assessed. Results: In both groups, the TDS decreased (in group A, from 25 ± 14 to 16 ± 14, P < 0.01; in group B, from 27 ± 9 to 19 ± 10, P < 0.01), the H/M increased (in group A, from 1.67 ± 0.31 to 2.01 ± 0.36, P < 0.01; in group B, from 1.68 ± 0.21 to 1.93 ± 0.32, P < 0.01), the LVEF increased (in group A, from 31% ± 10% to 48% ± 10%, P < 0.01; in group B, from 28% ± 9% to 47% ± 15%, P < 0.01), and the NYHA functional class improved (in group A, from 2.9 ± 0.3 to 1.7 ± 0.5, P < 0.01; in group B, from 2.8 ± 0.6 to 1.7 ± 0.6, P < 0.01). The change in LVEF was mildly correlated with the change in the TDS in group A (r = 0.41) as well as in group B (r = 0.53). In the patients with a favorable response in the TDS or H/M, the NYHA class improved more than in the patients without a favorable response (P < 0.05). Conclusion: Carvedilol treatment can improve cardiac function, symptoms, and cardiac sympathetic nerve activity in patients with DCM to a similar extent as metoprolol treatment. The improvement of cardiac function and symptoms is related to the improvement of cardiac sympathetic nerve activity.

Key Words: ¹²³I-MIBG imaging • metoprolol • carvedilol • dilated cardiomyopathy

This article has been cited by other articles:

				S. Kasama, T. Toyama, H. Sumino, M. Nakazawa, N. Matsumoto, Y. Sato, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, et al. Prognostic Value of Serial Cardiac 123I-MIBG Imaging in Patients with Stabilized Chronic Heart Failure and Reduced Left Ventricular Ejection Fraction J. Nucl. Med., June 1, 2008; 49(6): 907 - 914. [Abstract] [Full Text] [PDF]

				S. Kasama, T. Toyama, H. Sumino, N. Matsumoto, Y. Sato, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi Additive Effects of Spironolactone and Candesartan on Cardiac Sympathetic Nerve Activity and Left Ventricular Remodeling in Patients with Congestive Heart Failure J. Nucl. Med., December 1, 2007; 48(12): 1993 - 2000. [Abstract] [Full Text] [PDF]

				P. A. Gould, G. Kong, V. Kalff, S. J. Duffy, A. J. Taylor, M. J. Kelly, and D. M. Kaye Improvement in cardiac adrenergic function post biventricular pacing for heart failure Europace, September 1, 2007; 9(9): 751 - 756. [Abstract] [Full Text] [PDF]

				S Kasama, T Toyama, T Hatori, H Sumino, H Kumakura, Y Takayama, S Ichikawa, T Suzuki, and M Kurabayashi Effects of torasemide on cardiac sympathetic nerve activity and left ventricular remodelling in patients with congestive heart failure Heart, October 1, 2006; 92(10): 1434 - 1440. [Abstract] [Full Text] [PDF]

				A. Cohen-Solal, F. Rouzet, A. Berdeaux, D. Le Guludec, E. Abergel, A. Syrota, and P. Merlet Effects of Carvedilol on Myocardial Sympathetic Innervation in Patients with Chronic Heart Failure J. Nucl. Med., November 1, 2005; 46(11): 1796 - 1803. [Abstract] [Full Text] [PDF]

				S. Kasama, T. Toyama, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi Effects of candesartan on cardiac sympathetic nerve activity in patients with congestive heart failure and preserved left ventricular ejection fraction J. Am. Coll. Cardiol., March 1, 2005; 45(5): 661 - 667. [Abstract] [Full Text] [PDF]