[Effects of carvedilol on functional capacity, left ventricular function, catecholamines and oxidative stress in patients with chronic heart failure].
OBJECTIVE
Carvedilol is an antioxidant and adrenergic antagonist with demonstrated benefits in terms of mortality from heart failure (HF). The aim of the present study was to evaluate clinical parameters, left ventricular function, oxidative stress levels and neurohumoral status at baseline and after 6 months of treatment with carvedilol in patients with chronic HF.


METHODS
Thirty patients with chronic HF that was stable without beta blocker treatment were included. Functional class was II or III, and left ventricular ejection fraction (LVEF) was < 40%. Mahler score, distance walked in 6 min, peak oxygen consumption, LVEF, plasma catecholamine (norepinephrine) concentration and oxidative stress parameters were evaluated at baseline and after 6 months of treatment with carvedilol.


RESULTS
Mean age was 59 (2) years, and 23 patients were men. After 6 months of treatment there were clinical improvements as measured by the Mahler score (from 6.8 to 11.0 points; P=.001) and the 6-min walk distance (from 499 [18] to 534 [17] m; P =.032), but no changes in peak oxygen consumption. The LVEF increased from 24 (1) to 31 (2)% (P=.003). In patients with chronic HF, plasma malondialdehyde concentration was significantly lower after 6 months (decrease from 2.4 [0.2] to 1.1 [0.2] micromol/l; P<.001). No significant changes were observed in plasma catecholamine levels or antioxidant enzyme activities.


CONCLUSIONS
In patients with chronic HF, carvedilol treatment for 6 months was associated with clinical improvements, increased left ventricular function and decreased plasma concentrations of malondialdehyde, with no changes in plasma catecholamine levels.
Castro
Pablo
P
Departamento de Enfermedades Cardiovasculares, Hospital Clínico Universidad Católica de Chile, Santiago de Chile, Chile. pcastro@med.puc.cl
Pérez
Osvaldo
O
Greig
Douglas
D
Díaz-Araya
Guillermo
G
Moraga
Francisco
F
Chiong
Mario
M
Troncoso
Rodrigo
R
Padilla
Ivonne
I
Vukasovic
Jose L
JL
Corbalán
Ramón
R
Lavandero
Sergio
S
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000368:Aged; D002227:Carbazoles / Q000494:pharmacology*; D000077261:Carvedilol; D002395:Catecholamines / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects* / Q000502:physiology; D011412:Propanolamines / Q000494:pharmacology*; D011877:Radionuclide Imaging; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome; D016276:Ventricular Function; D016277:Ventricular Function, Left / Q000187:drug effects*
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D002395:Catecholamines; D011412:Propanolamines; D000077261:Carvedilol