Beneficial effects of carvedilol as a concomitant therapy to angiotensin-converting enzyme inhibitor in patients with ischemic left ventricular systolic dysfunction

Can J Physiol Pharmacol. 2007 Feb;85(2):193-9. doi: 10.1139/y07-006.

Abstract

Studies are scant on the effects of short-term carvedilol treatment as an adjuvant to angiotensin-converting enzyme (ACE) inhibitor in patients with left ventricular (LV) systolic dysfunction. The objective of this study was to find the effects of short-term treatment of carvedilol on patients with ischemic LV systolic dysfunction (defined as LV ejection fraction (LVEF) <or=30% on 2D echocardiography) undergoing coronary artery bypass surgery (CABG). There were 74 patients that received ACE inhibitor without any beta-blocker (control) and 67 patients that received carvedilol in addition to ACE inhibitor following CABG (carvedilol group). After 1 month of drug administration following CABG, the control group was found to have significantly greater percent improvement in LVEF (29.1% +/- 5.39%) as compared with the carvedilol group (15.3% +/- 4.89%). However, after 3 and 6 months, LVEF levels were found to be significantly greater in the carvedilol group as compared with the control group. Further, at 6 months of drug administration, LV end systolic diameter was significantly less in the carvedilol group (39.11 +/- 1.10 mm) as compared with the control group (43.49 +/- 1.39 mm). Thus, carvedilol produces beneficial effect on short-term administration in terms of LV contractility when given along with ACE inhibitor as compared with ACE inhibitor therapy alone.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage*
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
  • Carbazoles / administration & dosage*
  • Carvedilol
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / drug therapy*
  • Myocardial Ischemia / physiopathology
  • Oxidative Stress
  • Propanolamines / administration & dosage*
  • Prospective Studies
  • Stroke Volume / drug effects
  • Systole / drug effects*
  • Ventricular Dysfunction, Left / drug therapy*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Remodeling / drug effects

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Carbazoles
  • Propanolamines
  • Carvedilol