Congestive Heart FailureEffects of carvedilol on left ventricular mass, chamber geometry, and mitral regurgitation in chronic heart failure☆
Section snippets
Study design
The clinical study design, patient characteristics, and primary outcomes of the treatment phase using carvedilol have been published previously.4 This study was a prospective, randomized, double-blind, placebo-controlled trial of 4 months duration. Recruited subjects were randomized to carvedilol or placebo on a 3:2 basis with a block size of 5. At the end of 4 months all patients were placed on open-label carvedilol and followed for an additional 8 months. End points of the study included
Results
Average LV thickness was measured by 2-dimensional echocardiography. Twenty-one patients were excluded from analysis of LV mass secondary to inadequate echo windows. In the carvedilol group LV thickness decreased from 1.31 ± 0.04 cm at baseline to 1.22 ± 0.06 cm at 4 months (Figure 1 , p = 0.04) and in the placebo group LV thickness increased from 1.33 ± 0.04 to 1.41 ± 0.04 cm (p = 0.06). Between-group analysis indicated significant differences in the slopes (p = 0.01) and levels at 4 months (p
Discussion
The major finding of this study is that carvedilol can partially reverse LV hypertrophy and the altered chamber geometry that occurs in chronic heart failure, or partially reverse the remodeling process. Therefore, carvedilol improves LV ejection fraction while decreasing LV mass and improving cardiac geometry. The reversal of the remodeling process is detectable by 4 months of treatment and continues for up to 12 months. These changes were also associated with a decrease in the amount of MR.
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Cited by (0)
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This study was supported by Grant HL48013 from the National Institutes of Health, Bethesda, Maryland, and SmithKline Beecham, King of Prussia, Pennsylvania.