title: Protective effects of carvedilol against anthracycline-induced cardiomyopathy.
abstract: OBJECTIVE
  The aim of this study was to determine the protective effect of carvedilol in anthracycline (ANT)-induced cardiomyopathy (CMP).
  
  
  BACKGROUND
  Despite its broad effectiveness, ANT therapy is associated with ANT-induced CMP. Recent animal studies and experimental observations showed that carvedilol prevented development of CMP due to chemotherapeutics. However, there is no placebo-controlled clinical trial concerning prophylactic carvedilol use in preventing ANT-induced CMP.
  
  
  METHODS
  Patients in whom ANT therapy was planned were randomized to administration of carvedilol or placebo. We enrolled 25 patients in carvedilol and control groups. In the carvedilol group, 12.5 mg once-daily oral carvedilol was given during 6 months. The patients were evaluated with echocardiography before and after chemotherapy. Left ventricular ejection fraction (EF) and systolic and diastolic diameters were calculated.
  
  
  RESULTS
  At the end of 6 months of follow-up, 1 patient in the carvedilol group and 4 in the control group had died. Control EF was below 50% in 1 patient in the carvedilol group and in 5 in the control group. The mean EF of the carvedilol group was similar at baseline and control echocardiography (70.5 vs. 69.7, respectively; p = 0.3), but in the control group the mean EF at control echocardiography was significantly lower (68.9 vs. 52.3; p < 0.001). Both systolic and diastolic diameters were significantly increased compared with basal measures in the control group. In Doppler study, whereas E velocities in the carvedilol group decreased, E velocities and E/A ratios were significantly reduced in the control group.
  
  
  CONCLUSIONS
  Prophylactic use of carvedilol in patients receiving ANT may protect both systolic and diastolic functions of the left ventricle.
authors.affiliation: Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey. nihatkalay@hotmail.com
authors.forename: Nihat
authors.initials: N
authors.lastname: Kalay
authors.forename: Emrullah
authors.initials: E
authors.lastname: Basar
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ozdogru
authors.forename: Ozlem
authors.initials: O
authors.lastname: Er
authors.forename: Yakup
authors.initials: Y
authors.lastname: Cetinkaya
authors.forename: Ali
authors.initials: A
authors.lastname: Dogan
authors.forename: Tugrul
authors.initials: T
authors.lastname: Inanc
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Oguzhan
authors.forename: Namik Kemal
authors.initials: NK
authors.lastname: Eryol
authors.forename: Ramazan
authors.initials: R
authors.lastname: Topsakal
authors.forename: Ali
authors.initials: A
authors.lastname: Ergin
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects* / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects; D001783:Blood Flow Velocity; D002227:Carbazoles / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000517:prevention & control*; D000077261:Carvedilol; D003326:Coronary Circulation; D003971:Diastole; D004317:Doxorubicin / Q000009:adverse effects; D015150:Echocardiography, Doppler; D015251:Epirubicin / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000401:mortality; D011412:Propanolamines / Q000627:therapeutic use*; D016037:Single-Blind Method; D013318:Stroke Volume; D013599:Systole; D016277:Ventricular Function, Left
chemical_list: D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D015251:Epirubicin; D004317:Doxorubicin