Effects of carvedilol on left ventricular remodelling in chronic stable heart failure: a cardiovascular magnetic resonance study.
BACKGROUND
The ability of beta blockers to improve left ventricular function has been demonstrated, but data on the effects on cardiac remodelling are limited.


OBJECTIVE
To investigate, using cardiovascular magnetic resonance (CMR), the effects of carvedilol on left ventricular remodelling in patients with chronic stable heart failure and left ventricular systolic dysfunction caused by coronary artery disease.


METHODS
Randomised, double blind, placebo controlled study.


METHODS
Chronic stable heart failure.


METHODS
34 patients with chronic stable heart failure and left ventricular systolic function taking part in the CHRISTMAS trial (double blind carvedilol v placebo) underwent CMR before randomisation and after six months of treatment.


METHODS
Left ventricular remodelling at six months.


RESULTS
The carvedilol and placebo groups were well balanced at baseline, with no significant intergroup differences. Over the study period, there was a significant reduction in end systolic volume index (ESV(I)) and end diastolic volume index (EDV(I)) between the carvedilol and the placebo group (carvedilol -9 v placebo +3 ml/m2, p = 0.0004; carvedilol -8 v placebo 0 ml/m2, p = 0.05). The ejection fraction increased significantly between the groups (carvedilol +3% v placebo -2%, p = 0.003).


CONCLUSIONS
Treatment of chronic stable heart failure with carvedilol results in significant improvement in left ventricular volumes and function. These effects might contribute to the benefits of carvedilol on mortality and morbidity in patients with chronic heart failure.
Bellenger
N G
NG
Royal Brompton Hospital, London, UK.
Rajappan
K
K
Rahman
S L
SL
Lahiri
A
A
Raval
U
U
Webster
J
J
Murray
G D
GD
Coats
A J S
AJ
Cleland
J G F
JG
Pennell
D J
DJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D002227:Carbazoles / Q000627:therapeutic use*; D002303:Cardiac Output, Low / Q000188:drug therapy*; D000077261:Carvedilol; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D011412:Propanolamines / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000188:drug therapy*; D020257:Ventricular Remodeling / Q000187:drug effects*
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol