Effects of carvedilol on plasma B-type natriuretic peptide concentration and symptoms in patients with heart failure and preserved ejection fraction
Section snippets
Patients
We initially enrolled 48 consecutive outpatients referred to our heart failure clinic at Nagoya City University Hospital from April 1, 2000 to March 31, 2001, due to heart failure according to New York Heart Association (NYHA) functional class II or III and stage C of American College of Cardiology/American Heart Association guidelines for the evaluation and management of chronic heart failure in the adult.6 All patients met Framingham criteria for diagnosis of heart failure. LVEF, as assessed
Patient characteristics
There was no significant difference in baseline characteristics and treatment of patients between groups as listed in Table 1. Mean dosage of carvedilol at the end of the study was 10.9 mg/day (10.0, 77 to 14.0). Each patient using an angiotensin-converting enzyme inhibitor received 5 mg/day of enalapril. No patient received >80 mg/day of furosemide or >16 mg/day of torsemide. We administered 80 mg/day of valsartan to 2 patients on conventional therapy in whom treatment had failed.
Treatment failure and tolerability
Treatment
Discussion
In the present study, the addition of carvedilol to conventional therapy for 12 months decreased plasma BNP concentrations, alleviated symptoms, and increased exercise capacity in patients with heart failure and LVEF ≥45%. Treatment with carvedilol was tolerated as well as conventional therapy. Effects of β-adrenergic blockers in patients with preserved EF have not been tested in randomized trials except for the Swedish Evaluation of Diastolic Dysfunction in Congestive Heart Failure (SWEDIC),
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2013, American Heart JournalCitation Excerpt :In clinical trials involving anti–heart failure medications, the decline in BNP relative to baseline is far lower than the marker's RCV. For example, the natriuretic peptide concentrations decreased by only 35% among patients with heart failure who were successfully treated with carvedilol.14 In similar studies with metoprolol,15 valsartan,16 omapatrilat, and lisopril,17 the mean changes were 52%, 35%, 20%, and 36% respectively.
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2012, Nutrition, Metabolism and Cardiovascular DiseasesEffect of beta blockade on natriuretic peptides and copeptin in elderly patients with heart failure and preserved or reduced ejection fraction: Results from the CIBIS-ELD trial
2012, Clinical BiochemistryCitation Excerpt :Serial measurements of natriuretic peptides may be useful for monitoring and titration of HF treatment therapy [7]. While the effects of BB on natriuretic peptides have been reported in HFREF [8–13], there were only 2 randomized trials in HFPEF patients [14,15]. The reported responses are widely divergent, presumably reflecting differences between specific BBs and the effects of dose and duration of treatment and clinical state.