Influence of carvedilol on the benefits of physical training in patients with moderate chronic heart failure.
OBJECTIVE
To evaluate prospectively the impact of carvedilol on a short-term physical training program in stable patients with moderate chronic heart failure (CHF), and to analyze parameters predictive of improvement after training.


RESULTS
Thirty-eight patients with CHF were referred for cardiac rehabilitation. Etiology was ischemic in 26 patients, dilated in 12 patients and left ventricular ejection fraction was <35%. Patients were classified into three groups: group 1 (n=14)=ACE inhibitors, diuretics and digitalis; group 2 (n=11)=idem group 1+cardioselective beta-blocker; group 3 (n=13)=idem group 1+carvedilol. Exercise tests with VO2 measurement were performed before and after a 4-week exercise training program. Patients with carvedilol experienced a 16.6% increase in peak VO2 which was similar to the 13.9% increase in the group with cardioselective beta-blocker and to the 18.5% in the group without beta-blocker. Moreover non-ischemic etiology of CHF was the only parameter predictive of improvement after training (P=0.02).


CONCLUSIONS
Addition of carvedilol did not alter benefits of a short-term physical training program in patients with moderate CHF. No baseline characteristic except for etiology of CHF was predictive of a response to training.
Forissier
J F
JF
Centre de réadaptation cardiovasculaire Bois-Gibert, 37510, Ballan-Miré, France. bgibert@club-internet.fr
Vernochet
P
P
Bertrand
P
P
Charbonnier
B
B
Monpère
C
C
D000070:Acebutolol / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D002908:Chronic Disease; D005080:Exercise Test / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000534:rehabilitation*; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology; D026741:Physical Therapy Modalities; D011237:Predictive Value of Tests; D011412:Propanolamines / Q000627:therapeutic use*; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D000070:Acebutolol