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Clinical and hemodynamic effects of carvedilol in patients with hypertrophic cardiomyopathy

Abstract

Aim. To study carvedilol effectiveness in patients with hypertrophic cardiomyopathy (HCMP).
Material and methods. The study included 52 patients with HCMP (67% men and 33% women; mean age 40,7±3,1 yeas). All participants underwent clinical examination, six-minute walk test (6mwt), standard 12-lead electrocardiography (ECG), echocardiography (EchoCG), chest X-ray with cardio-thoracic index calculation, and angina severity assessment using a verbal assessment scale (VAS). All patients were divided into two groups: Group I (n=38) with interventricular wall thickness (IVWT) ≤20 mm; and Group II (n=14) with IVWT >20 mm. Carvedilol was titrated from the minimal dose of 6,25 mg/d to the maximal dose of 31,25 mg/d (b. i.d.). The treatment duration was 12 weeks.
Results. Carvedilol therapy was associated with an improvement of clinical and hemodynamic parameters (including reduced angina severity and improved left ventricular diastolic function, LVDF) in both groups. The effectiveness of conservative treatment was higher in patients with IVWT <20 mm.
Conclusion. In HCMP patients, the severity of clinical symptoms and non-specific ECG disturbances increased in parallel with the IVW hypertrophy progression. Carvedilol therapy demonstrated beneficial effects on clinical status, cardiac hemodynamics, and LVDF. These effects were maximal in patients with IVWT <20 mm.

About the Authors

T. A. Abdullaev
Republican Specialised Cardiology Centre
Uzbekistan
Tashkent



O. Kh. Allaberganov
Republican Specialised Cardiology Centre
Uzbekistan
Tashkent



B. U. Mardanov
Republican Specialised Cardiology Centre
Uzbekistan
Tashkent



R. D. Kurbanov
Republican Specialised Cardiology Centre
Uzbekistan
Tashkent



References

1. Джанашия П. Х., Маркелова И. В., Крыло ва Н. С. Сравни тельная оценка эффективности ивабрадина и атенолола у больных гипертрофической кардиомиопатией. РКЖ 2010; 1 (81): 59–64.

2. Michael AF, Gus JV. Management of Symptoms in Hypertrophic Cardiomyopathy. Circulation 2008; 117: 429–39.

3. Su Min Chang, Nasser ML, Jennifer F, William HS. Predictors of Outcome After Alcohol Septal Ablation Therapy in Patients With Hypertrophic Obstructive Cardiomyopathy. Circulation 2004; 109: 824–7.

4. Neaton JD, Grimm RH, Prineas RJ, et al. Оn behalf of the Treatment of Mild Hypertension Study Research Group: Treatment of Mild Hypertension Study. Final results. JAMA 1993; 270: 713–24.

5. McMurray J, Kober L, Robertson M, et al. Antiarrhythmic Effect of Carvedilol After Acute Myocardial Infarction. Results of the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) Trial. JACC 2005;45: 525–30.

6. Бояринов Г. А., Матусова Е. И., Военнов О. В. Острый коронарный синдром: специфика ситуации, реанимации и интенсивной терапии. 2004; НГМА: 80 стр.

7. Wigle ED, Rakowski H, Henderson MA, et al. Hypertrophic cardiomyopathy. Clinical spectrum and treatment. Circulation 1995; 92: 1680–92.

8. Spirito P, Siedman CE, McKenna WJ. The management of hypertrophic cardiomyopathy. N Engl J Med 1997; 336: 775–85.

9. Шипилова Т., Удрас А., Лане П. Течение и исход гипертрофической кардиомиопатии при 15–20 летнем наблюдении. Кардиология 1996; 1: 42–6.

10. Габрусенко С. А. Современные представления о диагностике и лечении больных гипертрофической кардиомиопатией. Сердце 2004; 3 (4): 191–6.

11. Якушин С. С., Филиппов Е. В. Гипертрофическая кардиомиопатия: результаты пятилетнего наблюдения. Болезни сердца и сосудов 2006; 2: 22–5.

12. Ferrans VJ, Morrow AG. Myocardial ultrastructure in idiopathic hypertrophic subaortic stenosis. Circulation 1972; 45: 769–92.

13. Амосова Е. Н. Кардиомиопатии: Руководство.- Киев: «Книга плюс» 1999; 425 с.

14. Марцевич С. Ю., Коняхина И. П., Алимова Е. В. и др. Сравнение эффективности карведилола и атенолола у больных стабильной стенокардией напряжения. Тер архив 2001; 1: 38–41.

15. Steffensen R, Grande P, Pedersen F, et al. Effects of atenolol and diltiazem on exercise tolerance and ambulatory ischaemia. Int J Cardiol 1993; 40: 143–53.

16. Eichstaedt H, Schroeder RJ, Auffermann W, Richter W. Regression of left ventricular hypertrophy. J Cardiovasc Pharmacol 1992;19 (Suppl. 1): S55–61.

17. Palazzuoli A, Carrera A, Calabria P, et al. Effects of carvedilol therapy on restrictive dia-stolic filling pattern in chronic heart failure. Am Heart J 2004;147 (1): E2.

18. Bergström A, Andersson B, Edner M, et al. Effect of carvedilol on diastolic function in patients with diastolic heart failure and preserved systolic function. Results of the Swedish Dopplerechocardiographic study (SWEDIC). Eur J Heart Fail 2004; 6 (4): 453–61.

19. Баитова Г. М., Бейшенкулов М. Т., Савченко Ж. В. и др. Влияние карведилола на диастолическую функцию левого желудочка у больных инфарктом миокарда. Вестник КРСУ 2002; 1: 13–5.


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For citations:


Abdullaev T.A., Allaberganov O.Kh., Mardanov B.U., Kurbanov R.D. Clinical and hemodynamic effects of carvedilol in patients with hypertrophic cardiomyopathy. Cardiovascular Therapy and Prevention. 2011;10(8):57-62. (In Russ.)

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