title: Carvedilol improves left atrial and left ventricular function and reserve in dilated cardiomyopathy after 1 year of treatment.
abstract: BACKGROUND
  The aim of this study was to evaluate the effects of carvedilol therapy on left atrial (LA) function in patients with heart failure from nonischemic dilated cardiomyopathy.
  
  
  RESULTS
  Thirty-five patients (42.4 +/- 13.5 years) in New York Heart Association functional Class II-III have been studied. A low-dose (20 mug.kg.min) echo-dobutamine study has been performed, before and 12 months after carvedilol therapy. Twelve months after carvedilol therapy, a significant improvement in LA and left ventricular (LV) function was observed. To investigate the beneficial effects of carvedilol, patients were separated into 2 groups according to the presence of pretreatment LV contractile reserve (CR) (ejection fraction [EF] increases >20% after dobutamine infusion): Group A consisted of 18 patients with CR and Group B of 17 patients without CR. After carvedilol treatment, both the LV and LA function were improved in group A (P < .01 for all). However, in group B, only the LA function was significantly improved (left atrial ejection volume increased from 10.4 +/- 3 mL to 15.4 +/- 6.7, P < .01 and LA ejection fraction from 19.6 +/- 45.3% to 29.4 +/- 12.5%, P < .01), whereas the LV contractile reserve has partially reappeared (EF from 29.9 +/- 4.5% at baseline, increased after dobutamine infusion to 35.8 +/- 6.8%, P < .0001).
  
  
  CONCLUSIONS
  In conclusion, carvedilol therapy is associated with improvement in both LV and LA functions in nonischemic dilated cardiomyopathy. In a subgroup of these patients, carvedilol may act differently on LV and LA function.
authors: Second Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Ioannis
authors: I
authors: Paraskevaidis
authors: Dimitrios
authors: D
authors: Farmakis
authors: John T
authors: JT
authors: Parissis
authors: Thomas
authors: T
authors: Dodouras
authors: Gerasimos
authors: G
authors: Filippatos
authors: Dimitrios
authors: D
authors: Tsiapras
authors: Dimitrios Th
authors: DT
authors: Kremastinos
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D016279:Atrial Function, Left / Q000187:drug effects* / Q000502:physiology; D002227:Carbazoles / Q000627:therapeutic use*; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D002316:Cardiotonic Agents / Q000008:administration & dosage; D000077261:Carvedilol; D004280:Dobutamine / Q000008:administration & dosage; D015150:Echocardiography, Doppler; D025401:Echocardiography, Stress; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000627:therapeutic use*; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
chemical_list: D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D002316:Cardiotonic Agents; D011412:Propanolamines; D000077261:Carvedilol; D004280:Dobutamine