Improvement in left ventricular function in response to carvedilol is accompanied by attenuation of neurohumoral activation in patients with dilated cardiomyopathy

Fujimura, Mitsunori; Yasumura, Yoshio; Ishida, Yoshiteru; Nakatani, Satoshi; Komamura, Kazuo; Yamagishi, Masakazu; Miyatake, Kunio

doi:10.1016/s1071-9164(00)80004-4

Cited by 48 publications

(27 citation statements)

References 37 publications

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“…31 In general, improvement in cardiac function is accompanied by improvement in the neurohumoral factors and the present study has shown that concomitant improvement in cardiac function and plasma BNP level occurs, independent of the -blocker used.…”

Section: Long-term Effects Of -Blockerssupporting

confidence: 59%

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Comparative Left Ventricular Functional and Neurohumoral Effects of Chronic Treatment With Carvedilol Versus Metoprolol in Patients With Dilated Cardiomyopathy

Hirooka

Yasumura²,

Ishida³

et al. 2001

Jpn Circ J

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Section: Long-term Effects Of -Blockerssupporting

confidence: 59%

“…In addition to conventional therapy, metoprolol was administered to 29 patients who entered the study between January 1, 1994 and December 31,1996. The initial dose was 5 mg daily and was doubled every week up to 40 mg daily.…”

Section: Administration Of -Blockersmentioning

confidence: 99%

Comparative Left Ventricular Functional and Neurohumoral Effects of Chronic Treatment With Carvedilol Versus Metoprolol in Patients With Dilated Cardiomyopathy

Hirooka

Yasumura²,

Ishida³

et al. 2001

Jpn Circ J

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“…Accordingly, changes in EF after 6 months of carvedilol for the entire cohort were correlated with changes in EDV and SV, and the determinants of SV (eg, preload volume, contractility, HR, and TPR) by a Pearson's correlation coefficient. Additionally, changes in parameters for the entire cohort, stratified by whether they did or did not exhibit a Ն5 percentage point increase in EF after 6 months of treatment, as has been done in prior studies, 19,20 were evaluated by a Student t test for paired comparisons. To determine the relative contributions of HR, TPR, and R es to changes in EF, multiple linear regression analysis was used.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms Underlying Improvements in Ejection Fraction With Carvedilol in Heart Failure

Maurer

Sackner‐Bernstein

Rumbarger

et al. 2009

Circ: Heart Failure

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Background-Reductions in heart rate (HR) with ␤-blocker therapy have been associated with improvements in ejection fraction (EF). However, the relative contributions of HR reduction, positive inotropism, afterload reduction, and reverse remodeling to improvements in EF are unknown. Methods and Results-Twenty-nine patients (63Ϯ12 years old) with New York Heart Association class II-III heart failure underwent serial measurements of left ventricular volumes using 3-dimensional echocardiography and blood pressures by sphygmomanometry at baseline, 2 weeks, 2, 6, and 12 months after initiation of carvedilol. From these parameters, left ventricular contractility (indexed by the end-systolic pressure-volume ratio), total peripheral resistance, and effective arterial elastance (E a ) were derived. Overall, EF increased by 7-percentage points after 6 months of therapy (from 25Ϯ9 to 32Ϯ9, PϽ0.0001). This change was due to an increase in stroke volume (PϽ0.001) with no significant change in end-diastolic volume (Pϭ0.15). The EF change correlated with increased contractility, decreased HR and decreased total peripheral resistance (PϽ0.003 in each case). In those patients whose EF increased at least 5 points, Ϸ60% of the increase was due to HR reduction, Ϸ30% was due to increased contractility, and Ͻ20% was due to the decrease in total peripheral resistance. Conclusions-Decreased

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“…6 Previous studies have suggested that ACEI, angiotensin receptor blocker, -blockers and spironolactone can improve the parameters of cardiac 123 I-MIBG scintigraphy and decrease plasma levels of BNP in patients with CHF. 16,23,[25][26][27][28][29][30][31][32][33][34][35][36] Both parameters of cardiac 123 I-MIBG scintigraphy and plasma BNP levels are useful surrogate markers for the management of CHF patients. We have reported that repeated measurements of cardiac 123 I-MIBG imaging parameters before and after 6-month optimized treatments are useful for predicting the prognoses of patients with moderate to severe CHF.…”

Section: Discussionmentioning

confidence: 99%

Beneficial Effect of Perindopril on Cardiac Sympathetic Nerve Activity and Brain Natriuretic Peptide in Patients With Chronic Heart Failure Comparison With Enalapril

Tsutamoto

Tanaka

Nishiyama

et al. 2008

Circ J

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BackgroundIn patients with chronic heart failure (CHF), it remains unclear whether perindopril is more cardioprotective than enalapril. Methods and Results Forty-five stable CHF outpatients undergoing conventional therapy including enalapril therapy were randomized to 2 groups [group I (n=24): continuous enalapril treatment; group II (n=21): enalapril was changed to perindopril]. Cardiac sympathetic nerve activity was evaluated using cardiac 123 I-metaiodobenzylguanidine (MIBG) scintigraphy, hemodynamic parameters and neurohumoral factors before and 6 months after treatment. There was no difference in baseline characteristics between the 2 groups. In group I, there were no changes in MIBG parameters, left ventricular ejection fraction (LVEF) or plasma level of brain natriuretic peptide (BNP). In contrast, in group II the delayed heart/mediastinum count ratio was significantly increased (2.0±0.07 vs 2.15±0.07, p=0.013) and the washout rate was significantly decreased (33.0±1.4 vs 30.5±1.2, p=0.030) after 6 months compared with the baseline value. In addition, LVEF was significantly increased and the plasma BNP level was significantly decreased. Conclusion These findings suggest that for the treatment of CHF, perindopril is superior to enalapril with respect of cardiac sympathetic nerve activity and BNP. (Circ J 2008; 72: 740 -746)

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Improvement in left ventricular function in response to carvedilol is accompanied by attenuation of neurohumoral activation in patients with dilated cardiomyopathy

Cited by 48 publications

References 37 publications

Comparative Left Ventricular Functional and Neurohumoral Effects of Chronic Treatment With Carvedilol Versus Metoprolol in Patients With Dilated Cardiomyopathy

Comparative Left Ventricular Functional and Neurohumoral Effects of Chronic Treatment With Carvedilol Versus Metoprolol in Patients With Dilated Cardiomyopathy

Mechanisms Underlying Improvements in Ejection Fraction With Carvedilol in Heart Failure

Beneficial Effect of Perindopril on Cardiac Sympathetic Nerve Activity and Brain Natriuretic Peptide in Patients With Chronic Heart Failure Comparison With Enalapril

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