The effect of beta-blocker (carvedilol) therapy on N-terminal pro-brain natriuretic peptide levels and echocardiographic findings in patients with congestive heart failure.
BACKGROUND
The favorable effects of beta-blockers on decreasing mortality in contemporary heart failure management have been demonstrated in recent years. N-terminal pro-brain natriuretic (NT-proBNP) peptide levels increase in patients with heart failure. The purpose of this study was to investigate the correlation between the NT-proBNP levels and echocardiographic findings for the patients who received carvedilol therapy in addition to standard therapy for congestive heart failure.


RESULTS
A total of 25 patients with symptomatic congestive heart failure and 25 healthy individuals were enrolled in the study. Before introducing beta-blocker into their therapy regimens, baseline transthoracic echocardiography recordings were made and venous blood samples were drawn for establishing NT-proBNP levels. The patients were administered with a minimum dose of carvedilol. Three months after reaching the maximum tolerable dose, blood samples were drawn from the patients once again for NT-proBNP measurements, and transthoracic echocardiography was performed. There was a significant drop in plasma NT-proBNP levels at the end of the study in comparison to the baseline values (baseline: 381.20+/-35.06 pg/mL, at the end of the third month: 254.44+/-28.64 pg/mL; P < 0.001). While left ventricular end-diastolic and end-systolic diameters were observed to have significantly decreased as a result of the therapy (P < 0.001), left ventricular ejection fraction (P<0.001) was established to have increased significantly.


CONCLUSIONS
Carvedilol therapy resulted in a marked decrease in plasma NT-proBNP levels and increase left ventricular ejection fraction in patients with congestive heart failure.
Gundogdu
Fuat
F
Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey. gundogdudr@gmail.com
Bozkurt
Engin
E
Kiziltunc
Ahmet
A
Sevimli
Serdar
S
Arslan
Sakir
S
Gurlertop
Yekta
Y
Senocak
Huseyin
H
Karakelleoglu
Sule
S
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002227:Carbazoles / Q000494:pharmacology / Q000627:therapeutic use*; D000077261:Carvedilol; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011412:Propanolamines / Q000494:pharmacology / Q000627:therapeutic use*; D013318:Stroke Volume; D016277:Ventricular Function, Left
D000319:Adrenergic beta-Antagonists; D015415:Biomarkers; D002227:Carbazoles; D010446:Peptide Fragments; D011412:Propanolamines; C109794:pro-brain natriuretic peptide (1-76); D000077261:Carvedilol; D020097:Natriuretic Peptide, Brain