TO STUDY THE EFFECT OF BETA BLOCKER (CARVEDILOL) IN THE MANAGEMENT OF HEART FAILURE
Background and objectives: Congestive heart failure (CHF) continues to be a major clinical and public health problem with shift in etiology from hypertension, valvular heart disease to ischaemia. Carvedilol is a non-selective beta-blocker with Î±1- blocking activity. In the present study, the efficacy of Carvedilol, to increase the baseline left ventricular ejection fraction and heart rate, effect on blood pressure was assessed.
Materials and methods: A total number of 40 patients were enrolled in the study, 20 were heart failure patients and 20 were age-sex matched healthy controls. After the study period of 24 weeks, the efficacy of carvedilol in reducing heart rate, systolic blood pressure, diastolic blood pressure and left ventricular ejection fraction were evaluated.
Results: Carvedilol when given in low doses, was effective in increasing left ventricular ejection fractionÂ from (31.73 Â± 2.28 %) to (40.85 Â± 7.51 %) with p< 0.0001, decreasing heart rate from (80.95 Â± 5.10) to (71.50 Â± 6.11) beats / min, with p<0.0001, and reducing systolic blood pressure 5.25 Â± 4.99 with p<0.0006and diastolic blood pressure 6.50 Â± 6.71 with p<0.4077
Conclusion: Carvedilol is a non-selective beta-blocker with Î±1- blocking activity and when given in low doses, increases cardiac ejection fraction, decreases ventricular mass, improves the shape of the ventricle, and reduces systolic and diastolic volumes. In conclusion from our study, Carvedilol increases Â the baseline left ventricular ejection fraction and heart rate Â more significantly in the patients than in the controls.
2. Lip GYH, Gibbs CR, et al. BMJ 2000; 320: 104-107.
3. McKelvie RS, Benedict CR, et al. BMJ 1999; 318: 1400-1402.
4. Kenchaiah S, Narula J, Vasan RS, Med Clin North Am 2004;88:1145-72.
5. Coats AJS.Medicine 1998; 26: 116-121.
6. McDonagh TA, Dargie HJ. Medicine 1998; 26: 111-115.
7. Watson RDS, Gibbs CR, et al. BMJ 2000; 320: 236-239.
8. Hall S, Cigarroa CG, Marxoux L, et al. J Am Coll Cardiol 1995; 25: 1154-61.
9. Bristow MR, Gilbert EM. Eur Heart J 1995; 16(suppl F): 20-31.
10. Eichorn EJ, Bristow MR. Circulation 1996; 94: 2285-96.
11. Rendqvist B, Elam M, Bergmann-Sverrisdottir Y, Eisenhofer G, Friberg P. Circulation 1997; 95: 169-75.
12. Bristow MR. N Engl J Med 1984; 311: 850-1.
13. Anversa P, Ricci R, Olivetti G. J Am Coll Cardiol 1986; 7: 1140-9.
14. Mann DL, Kent RL, Pardons B, Cooper IV. Circulation 1992; 85: 790- 804.
15. Communal C, Singh K, Pimentel DR, Collucci WS. Circulation 1998; 98: 1329-34.
16. Cohn JN, Levine TB, Olivari MT, et al. N Engl J Med 1984; 311: 819-23.
17. Braunwaldâ€s Heart disease A text book of cardiovascular Medicine 8th page 4, edition chapter 23 page 563
18. Braunwald E heart failure; an overview in fishma AP, editor heart failure, Newyork, McGraw-hill 1977.
19. Denolin h et al the definition of heart failure,Eur heart J 1983,4-445-46.
20. Ho KK, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: the Framingham Study. J Am Coll Cardiol 1993;22(Suppl A):6A-13A.
21. GOODMAN AND GILMANS the pharmacological basis of therapeutics, 11 edition page 869-895.
22. American Heart Association Heart disease and stroke statistics 2004 update, Dallas Texas American Heart Association 2003 pp 1-48.
23. www.acc.org heart failure guidelines.
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