Target organs in patients with post-infarction chronic heart failure: dynamics during complex therapy including beta-adrenoblockers

• Published in: Kardiovaskuli͡a︡rnai͡a︡ terapii͡a︡ i profilaktika Vol. 7; no. 4; pp. 59 - 63
• Main Authors: I. P. Rubesh, L. A. Nekrutenko, A. V. Tuev, Yu. V. Larina, A. V. Agafonov
• Format: Journal Article
• Language: Russian
• Published: SILICEA-POLIGRAF» LLC 01.08.2008
• Subjects: adrenoblockers; chronic heart failure; endothelial dysfunction; target organs
• ISSN: 1728-8800; 2619-0125

Aim. To study the effects of carvedilol and metoprolol tartrate on endothelium mono-layer and remodeling of myocardium, large vessels and kidneys in patients with post-infarction chronic heart failure (CHF).Material and methods. The study included 50 patients (33 males, 66 %) with stable post-infarction chronic heart failure (CHF), Functional Class (FC) II-III. Mean CHF duration was 5,22+0,67 years. In 41,7 % patients, FC II CHF was diagnosed, in 58,3 % - FC III CHF. Clinical examination was performed at baseline and after 4 months of beta-adrenoblocker therapy. Main group (n=25) was administered carvedilol, control group - metoprolol tar-trate(n=25). Daily dose was titrated gradually; in carvedilol group, itwas43,ll±l,84 mg/d, in metoprolol group - 128,75+8,63 mg/d. Myocardial structure and function were assessed by echocardiography (EchoCG), vessel wall structure - by measuring intima-media thickness in common carotid arteries (CCA IMT). Endothelium monolayer and kidney function were assessed by measuring microalbuminuria (MAU) level.Results. Four-month carvedilol therapy was associated with a substantial decrease in MAU (-47,4 %) and CCA IMT (-10,6 %); in metoprolol group, these changes were not significant. EchoCG results demonstrated a significant left cardiac chamber reduction.Conclusion. Carvedilol improved endothelial function, facilitated reverse remodeling of myocardium, vessel wall and kidneys. Therefore, carvedilol therapy might be recommended for target organ protection in CHF