Target organs in patients with post-infarction chronic heart failure: dynamics during complex therapy including beta-adrenoblockers
Abstract
Aim. To study the effects of carvedilol and metoprolol tartrate on endothelium mono-layer and remodeling of myocardium, large vessels and kidneys in patients with post-infarction chronic heart failure (CHF).
Material and methods. The study included 50 patients (33 males, 66 %) with stable post-infarction chronic heart failure (CHF), Functional Class (FC) II-III. Mean CHF duration was 5,22+0,67 years. In 41,7 % patients, FC II CHF was diagnosed, in 58,3 % - FC III CHF. Clinical examination was performed at baseline and after 4 months of beta-adrenoblocker therapy. Main group (n=25) was administered carvedilol, control group - metoprolol tar-trate(n=25). Daily dose was titrated gradually; in carvedilol group, itwas43,ll±l,84 mg/d, in metoprolol group - 128,75+8,63 mg/d. Myocardial structure and function were assessed by echocardiography (EchoCG), vessel wall structure - by measuring intima-media thickness in common carotid arteries (CCA IMT). Endothelium monolayer and kidney function were assessed by measuring microalbuminuria (MAU) level.
Results. Four-month carvedilol therapy was associated with a substantial decrease in MAU (-47,4 %) and CCA IMT (-10,6 %); in metoprolol group, these changes were not significant. EchoCG results demonstrated a significant left cardiac chamber reduction.
Conclusion. Carvedilol improved endothelial function, facilitated reverse remodeling of myocardium, vessel wall and kidneys. Therefore, carvedilol therapy might be recommended for target organ protection in CHF
About the Authors
I. P. Rubesh
Academician E.A. Vagner Perm State Medical Academy. Perm
Russian Federation
Russian Federation
L. A. Nekrutenko
Academician E.A. Vagner Perm State Medical Academy. Perm
Russian Federation
Russian Federation
A. V. Tuev
Academician E.A. Vagner Perm State Medical Academy. Perm
Russian Federation
Russian Federation
Yu. V. Larina
Academician E.A. Vagner Perm State Medical Academy. Perm
Russian Federation
Russian Federation
A. V. Agafonov
Academician E.A. Vagner Perm State Medical Academy. Perm
Russian Federation
Russian Federation
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Review
For citations:
Rubesh I.P., Nekrutenko L.A., Tuev A.V., Larina Yu.V., Agafonov A.V. Target organs in patients with post-infarction chronic heart failure: dynamics during complex therapy including beta-adrenoblockers. Cardiovascular Therapy and Prevention. 2008;7(4):59-63. (In Russ.)
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