Long-term carvedilol therapy effects on left ventricular remodeling and glycemia in patients with chronic heart failure and Type 2 diabetes mellitus
Abstract
Aim. To study the effects of long6term carvedilol treatment on left ventricular (LV) remodeling and glycemia control parameters in patients with chronic heart failure (CHF) due to post6infarction cardiosclerosis, and Type 2 diabetes mellitus (DM-2).
Material and methods. This 12-month study included 30 patients with functional Class (FC) II-III CHF by NYHA classification, LV ejection fraction (EF) <40% and DM-2. Carvedilol was administered in the daily dose of 6,25-
25 mg.
Results. Carvedilol therapy was associated with substantial heart rate reduction: from 103,5±4,6 to 79,7±2,3 bpm (р<0,001). After 12 months, end-diastolic and end-systolic volumes decreased from 199,4±32,7 to 182,7±36,8
and from 132,0±27,9 to 112,8±31,3 ml, respectively (р<0,001), LV EF increased from 34,22±3,80 to 39,04±5,39%. Carvedilol therapy did not affect glycemia levels: 178,0±12,97 mg/dl at baseline, 180,27±12,72 mg/dl in the end of the study (р>0,05).
Conclusion. Long-term carvedilol therapy was associated with improved clinic and hemodynamic status, as well as delayed LV remodeling, without affecting glycemia levels in patients with CHF and DM-2.
About the Authors
R. R. Samedov
Academician D.M. Abdullaev Research Institute of Cardiology. Baku
Azerbaijan
Azerbaijan
A. B. Bakhshaliev
Academician D.M. Abdullaev Research Institute of Cardiology. Baku
Azerbaijan
Azerbaijan
References
1. Donnelly R, Emslie-Smith AM, Gardner ID, et al. ABC of arterial and venous disease: vascular complications of diabetes. BMJ 2000; 320: 1062-6.
2. Vaur L, Gueret P, Lievre M, et al. Development of congestive heart failure in type 2 diabetic patients with microalbuminuria and proteinuria. Diabetes Care 2003; 26: 855-60.
3. Беленков Ю.Н., Мареев В.Ю., Агеев Ф.Т. Хроническая сердечная недостаточность. Избранные лекции по кардиологии. Москва «ГЭОТАР-Медиа» 2006; Лекция 8: 162-3.
4. Swedberg K, Cleland J, Dargie H, et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): the Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005; 26: 1115-40.
5. Flather MD, Shibata MC, Coats AJ, et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 2005; 26: 215-25.
6. Lysko PG, Webb CL, Gu JL, et al. A comparison of carvedilol and metoprolol antioxidant activities in vitro. J Cardiovasc Pharmacol 2000; 36(2): 277-81.
7. Packer M, Coats AJ, Fowler MB, et al. Effect of carvedilol on survivalin severe CHF. N Engl J Med 2001; 344: 1651-8.
8. Nagatsu M, Spinale FG, Koide M, et al. Bradicardia and the role of beta-blocade in the amelioration of left ventricular dysfunction. Circulation 2000; 101: 653-9.
9. Lechat PP, Packer M, Chalon S, et al. Clinical effects of β-adrenergic blockade in chronic heart failure: a meta-analysis of double-blind, placebo-controlled, randomized trials. Circulation 1998; 98: 1184-91.
10. ESC Guidelines for the diagnosis and treatment of chronic heart failure 2005. Effect of metoprolol CR/XL in CHF: Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT6HF). Lancet 1999; 353: 2001-7.
11. Holzgreve H, Nakov R, Beck K, Janka HU. Antihypertensive therapy with verapamil SR plus trandolapril versus atenolol plus chlorthalidone on glycemic control. Am J Hypertens 2003; 16: 381-6.
12. Khaw KT, Wareham N, Bingham S, et al. Association of hemoglobin A1c with cardio-vascular disease and mortality in adults: the European Prospective Investigation into Cancer in Norfolk. Ann Intern Med 2004; 141: 413-20.
13. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA 2004; 291: 335-41.
Review
For citations:
Samedov R.R., Bakhshaliev A.B. Long-term carvedilol therapy effects on left ventricular remodeling and glycemia in patients with chronic heart failure and Type 2 diabetes mellitus. Cardiovascular Therapy and Prevention. 2008;7(1):59-62. (In Russ.)
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