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Purpose: To evaluate the efficacy and safety of high-dose Carvedilol( C 40mg per day) in Japanese patients with chronic heart failure. Method: Under the administration of C 20mg , the patients who showed EF 200pg/ml or moderate heart failure symptoms were included with informed consent. 15 patients (M:12, F:3, age57.2 ± 15.2, DCM:8, ICM:6, Sarcoidosis:1) were up-titrated C2.5mg per month to 40mg. NYHA class, BNP, EF, LVDd, CTR, systolic BP, heart rate and adverse event were evaluated at C0 , C20 and C40mg . Result: 12 patients reached to 40mg with no trouble, 1 to 35mg because of worsened heart failure, 2 to 30mg, one for bradycardia, the other for hypotension. NYHA ranking shows the tendency of dose related improvement. (3.1 ± 0.5, 2.1 ± 0.4 and 1.9 ± 0.5 p = 0.07) BNP shows the significant dose related improvement.(682 ± 352, 342 ± 278 and 183 ± 150pg/ml p C0 and C20 , however show the similar value in C20 and C40. (EF:25.3 ± 6.8, 33.2 ± 11.7 and 35.0 ± 15.6%, LVDd:64.7 ± 5.4, 62.9 ± 7.0 and 61.4 ± 10.8mm, CTR:60.6 ± 6.6, 56.9 ± 7.9 and 54.9 ± 4.9%). Systolic Bp and HR also shows the similar value in C20 and C40 . 6 patients during C20 period were admitted to hospital, the other hand during C40 period (12.4 ± 6.8months) only 3 patients admitted because of cardiovascular event. Conclusion: High-dose Carvedilol (40 mg) showed the efficacy and safety in the treatment of Japanese patients with chronic systolic heart failure. |
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