title: Persistent left bundle branch block in a patient with dilated cardiomyopathy that improved with low dose carvedilol therapy.
abstract: A 43-year-old Japanese woman with dilated cardiomyopathy had complete left ventricular bundle branch block (CLBBB), which had persisted for at least two years. At the time of admission, the serum brain natriuretic peptide (BNP) concentration was 502 pg/mL (normal range, 0-18 pg/mL), the left ventricular diastolic dimension (LVDd) was 59 mm, the left ventricular systolic dimension (LVDs) was 54 mm, the %fractional shortening (FS) was 8%, and the left ventricular ejection fraction (LVEF) was 19.7% by echocardiography. Low dose carvedilol was initiated for the treatment of heart failure. Adverse effects, such as progression of cardiac conduction disturbances, did not occur after initiation of carvedilol therapy. About one year after initiation of carvedilol therapy, the CLBBB disappeared and a significant improvement in left ventricular function was noted. The LVDd was 44 mm, the LVDs was 30 mm, the %FS was 33%, and the LVEF was 61%, and the serum BNP concentration was decreased to 18.5 pg/mL. We describe a case in which low dose carvedilol was effective for treating both CLBBB and left ventricular function.
authors.affiliation: Division of Cardiovascular Medicine, Toyama Red Cross Hospital, Toyama, Japan.
authors.forename: Bunji
authors.initials: B
authors.lastname: Kaku
authors.forename: Takao
authors.initials: T
authors.lastname: Sato
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nakatani
authors.forename: Shoji
authors.initials: S
authors.lastname: Katsuda
authors.forename: Tomio
authors.initials: T
authors.lastname: Taguchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nitta
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hiraiwa
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000328:Adult; D002037:Bundle-Branch Block / Q000150:complications / Q000188:drug therapy*; D002227:Carbazoles / Q000008:administration & dosage*; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000188:drug therapy*; D000077261:Carvedilol; D005260:Female; D006801:Humans; D011412:Propanolamines / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000317:Adrenergic alpha-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol