Carvedilol in heart failure.
Sustained oral treatment with beta blockers has been shown to improve symptoms in patients with chronic heart failure. In non-placebo-controlled trials, the administration initially of a low dose, gradually increased over a period of weeks has been demonstrated to improve both symptoms, exercise capacity and left-ventricular ejection fraction. The rationale for this treatment is the enhanced adrenergic stimulation present in heart failure which results in decreased sensitivity and density of myocardial beta-receptors. Beta blockers may decrease this pathological adrenergic drive. Carvedilol, in addition to its beta-blocking properties, is a vasodilator and is theoretically more suitable than earlier compounds of its potential to further decrease left-ventricular afterload. Recent studies have demonstrated symptomatic improvement with carvedilol in patients with heart failure, and a multicentre trial has been designed to evaluate its efficacy and safety.
Kelly
D T
DT
Hallstrom Institute of Cardiology, University of Sydney, Australia.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use*; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy; D000077261:Carvedilol; D016166:Free Radical Scavengers; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D011412:Propanolamines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D016166:Free Radical Scavengers; D011412:Propanolamines; D014665:Vasodilator Agents; D000077261:Carvedilol