Abstract
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Objectives: Carvedilol or amiodarone therapy was reported to be effective in patients with dilated cardiomyopathy (DCM). But the usefulness of the combined therapy was not reported. Now, we compared 15 patients (M/F=3/12, age=58+/-12y.) (Group A) with DCM receiving carvedilol (dose 10 mg/d) and amiodarone (dose 100 mg/d) with 15 patients (M/F=3/12, age=62+/-11y.) (Group B) with DCM receiving only carvedilol (dose 10 mg/d).
Methods: Patients were studied before and after 1 year of treatment (1Y). Cardiac symptom using NYHA class, exercise capacity using specific-activity-scale (SAS) and brain natriuretic peptide (BNP) were assessed. Cardiac sympathetic nerve activity was estimated using total defect score (TDS) and H/M ratio of delayed MIBG and washout rate (WR). Moreover LVEF, end-diastolic volume (EDV) and end-systolic volume (ESV) using Tc-99m-MIBI QGS were calculated.
Results: There were no differences on background treatment and other baseline characteristics between two groups. Some values of group A were better (p<0.05) than group B in delta-TDS (15+/-8 vs. 8+/-7) of MIBG imaging, delta-LVEF (25+/-12% vs. 15+/-14%), NYHA class (1Y) (1.4+/-0.5 vs. 1.9+/-0.5), SAS (1Y) (7.3+/-0.7 Mets vs. 6.2+/-1.0 Mets) and BNP (1Y) (39+/-44 vs. 176+/-180). Delta WR of MIBG imaging in group A tended to be higher than that in group B (p=0.068). Delta means the improved change of value. There were no differences on other parameters including H/M ratio of MIBG imaging, EDV and ESV. In
Conclusions: In conclusion, the combined therapy of carvedilol and amiodarone is more effective to improve cardiac symptom, exercise capacity, cardiac function and cardiac sympathetic nerve activity in patients with DCM.
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