Mechanisms Underlying Improvements in Ejection Fraction With Carvedilol in Heart Failure
| Autor: | Jonathan Sackner-Bernstein, Mathew S. Maurer, Daniel Burkhoff, Madeline Yushak, Donald L. King, Lyna El-Khoury Rumbarger |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Adrenergic beta-Antagonists Carbazoles Echocardiography Three-Dimensional Blood Pressure Vasodilation Severity of Illness Index Ventricular Function Left Propanolamines Contractility Afterload Heart Rate Internal medicine Heart rate Humans Medicine Carvedilol Aged Heart Failure Ejection fraction Ventricular Remodeling business.industry Stroke Volume Arteries Stroke volume Middle Aged Sphygmomanometers medicine.disease Myocardial Contraction Elasticity Treatment Outcome Heart failure Cardiology Female Vascular Resistance Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Circulation: Heart Failure. 2:189-196 |
| ISSN: | 1941-3297 1941-3289 |
| Popis: | Background— Reductions in heart rate (HR) with β-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 (63�12 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 25�9 to 32�9, P P P =0.15). The EF change correlated with increased contractility, decreased HR and decreased total peripheral resistance ( P Conclusions— Decreased HR, improved chamber contractility and afterload reduction each contributed significantly to improved EF with carvedilol. |
| Databáze: | OpenAIRE |
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