Hemodynamic characterization of left ventricular function in experimental coxsackieviral myocarditis: effects of carvedilol and metoprolol.
BACKGROUND
Carvedilol, a vasodilating nonselective beta-adrenoceptor antagonist, but not metoprolol, a selective beta1-adrenoceptor antagonist, has been shown to increase the production of cardiac antiinflammatory cytokines in experimental myocarditis. However, the hemodynamic consequences of these differences had not been investigated until today. Therefore, we determined the effects of carvedilol and metoprolol on left ventricular function in a murine model of coxsackievirus B3 (CVB3)-induced myocarditis.


METHODS
BALB/c mice were inoculated with the coxsackie-B3 virus. Four and 10 days after infection, left ventricular function was investigated using a conductance micromanometer system. Additional groups were treated starting 24 h after infection using equipotent doses of carvedilol and metoprolol and studied on day 10.


RESULTS
On day 4, infected mice manifested increased afterload-enhanced contractility and abnormal diastolic function. On day 10, contractile function of untreated mice was impaired. Carvedilol significantly improved cardiac index and most systolic indices, whereas metoprolol was substantially less effective. Diastolic dysfunction was not influenced by either of the beta-adrenoceptor antagonists.


CONCLUSIONS
These hemodynamic data indicate that not only beta1-adrenoceptor blockade but also pleiotropic effects are involved in the cardioprotective effects of carvedilol on the pathophysiology of acute viral myocarditis.
Tschöpe
Carsten
C
Department of Cardiology and Pneumonology, Charite University Medicine of Berlin, Campus Benjamin Franklin UKBF, Hindenburgdamm 30, Berlin D-12220, Germany. ctschoepe@yahoo.com
Westermann
Dirk
D
Steendijk
Paul
P
Noutsias
Michael
M
Rutschow
Susanne
S
Weitz
Anneke
A
Schwimmbeck
Peter Lothar
PL
Schultheiss
Heinz-Peter
HP
Pauschinger
Matthias
M
D000818:Animals; D002227:Carbazoles / Q000494:pharmacology / Q000627:therapeutic use*; D000077261:Carvedilol; D003384:Coxsackievirus Infections / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008790:Metoprolol / Q000494:pharmacology / Q000627:therapeutic use*; D051379:Mice; D008807:Mice, Inbred BALB C; D009205:Myocarditis / Q000188:drug therapy* / Q000503:physiopathology; D011412:Propanolamines / Q000494:pharmacology / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D008790:Metoprolol