Beta-blocker therapy for cardiac dysfunction in patients with muscular dystrophy.
BACKGROUND
In muscular dystrophy, cardiac function deteriorates with time and heart failure is one of the major causes of death. Although the combination of angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers improves cardiac function in adults, little is known about the efficacy of those drugs in patients with muscular dystrophy.


RESULTS
The effect of the beta-blocker, carvedilol, and/or ACEI on ventricular function in patients with muscular dystrophy was studied. Carvedilol and an ACEI were given to 13 patients (ACEI group; mean age 18 years, range 7-27 years), and an ACEI only to 15 patients (carvedilol group; mean age 15 years, range 8-29 years). Diagnoses included Duchenne muscular dystrophy (n=25), Fukuyama muscular dystrophy (n=2), and Emery-Dreifuss muscular dystrophy (n=1). Echocardiographic parameters of the left ventricle were measured during the 2-3 years of follow-up. In the carvedilol group, combination therapy of carvedilol and an ACEI for 2 years resulted in a significant increase in left ventricular fractional shortening (LVFS). In the ACEI group, there was no significant change in LVFS. Left ventricular end-diastolic dimension increased in the ACEI group, but not in the carvedilol group.


CONCLUSIONS
Carvedilol plus an ACEI improves left ventricular systolic function in patients with muscular dystrophy.
Kajimoto
Hidemi
H
Department of Pediatric Cardiology, Tokyo Women's Medical University, Japan.
Ishigaki
Keiko
K
Okumura
Kenichi
K
Tomimatsu
Hirofumi
H
Nakazawa
Makoto
M
Saito
Kayoko
K
Osawa
Makiko
M
Nakanishi
Toshio
T
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use*; D002303:Cardiac Output, Low / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D000077261:Carvedilol; D002648:Child; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004452:Echocardiography; D006801:Humans; D009136:Muscular Dystrophies / Q000150:complications* / Q000503:physiopathology; D011412:Propanolamines / Q000627:therapeutic use*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol