open access

Vol 21, No 4 (2014)
Original articles
Published online: 2014-08-29
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Evaluation of beta-blockers on left ventricular dyssynchrony and reverse remodeling in idiopathic dilated cardiomyopathy: A randomized trial of carvedilol and metoprolol

Mehmet Gungor Kaya, Bahadir Sarli, Mahmut Akpek, Esma Gunduz Kaya, Mikail Yarlioglues, Ramazan Topsakal, Yat-Yin Lam
DOI: 10.5603/CJ.a2013.0149
·
Cardiol J 2014;21(4):434-441.

open access

Vol 21, No 4 (2014)
Original articles
Published online: 2014-08-29

Abstract

Background: The effect of b-blockage on cardiac dyssynchrony in idiopathic dilated cardio­myopathy (IDC) is unknown. This study evaluated the impact of carvedilol and metoprolol succinate on left ventricular (LV) dyssynchrony and reverse remodeling in IDC.

Methods: In this small, prospective, double-blind study, we randomly assigned 81 IDC pa­tients to receive carvedilol or metoprolol succinate. Echocardiographic measurements (dyssyn­chrony, LV volumes and ejection fraction [EF]) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were obtained at baseline and at first and sixth month of therapy.

Results: A total of 74 (91%) patients completed all investigations at sixth month (38 and 36 taking carvedilol and metoprolol succinate, respectively). In the carvedilol group, reduction in LV end diastolic volume (D LVEDV at 6 months, 50 ± 15 mL to 40 ± 17 mL, p = 0.03) and increase in LVEF (D LVEF, 7 ± 2% to 5 ± 3%, p = 0.02) was higher compared to the meto­prolol group. Also improvement in inter-ventricular dyssynchrony achieved with carvedilol was higher than metoprolol (D interventricular delay at 6 months, 11 ± 8 ms to 6 ± 7 ms, p = 0.03). However, improvement in intraventricular dyssynchrony was similar in the two groups (D intraventricular delay, 9 ± 7 ms to 9 ± 6 ms, p = 0.91). Improvements in LV mechanical dyssynchrony and reverse remodeling achieved with both drugs were accompanied by reduction in NT-proBNP levels in both carvedilol and metoprolol groups (1614 ± 685 pg/mL to 654 ± ± 488 pg/mL and 1686 ± 730 pg/mL to 583 ± 396 pg/mL, respectively, p < 0.001 for both).

Conclusions: Although reduction in LVEDV and increase in LVEF was higher with carvedilol, improvement in intraventricular dyssynchrony was similar in carvedilol and metoprolol groups.

Abstract

Background: The effect of b-blockage on cardiac dyssynchrony in idiopathic dilated cardio­myopathy (IDC) is unknown. This study evaluated the impact of carvedilol and metoprolol succinate on left ventricular (LV) dyssynchrony and reverse remodeling in IDC.

Methods: In this small, prospective, double-blind study, we randomly assigned 81 IDC pa­tients to receive carvedilol or metoprolol succinate. Echocardiographic measurements (dyssyn­chrony, LV volumes and ejection fraction [EF]) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were obtained at baseline and at first and sixth month of therapy.

Results: A total of 74 (91%) patients completed all investigations at sixth month (38 and 36 taking carvedilol and metoprolol succinate, respectively). In the carvedilol group, reduction in LV end diastolic volume (D LVEDV at 6 months, 50 ± 15 mL to 40 ± 17 mL, p = 0.03) and increase in LVEF (D LVEF, 7 ± 2% to 5 ± 3%, p = 0.02) was higher compared to the meto­prolol group. Also improvement in inter-ventricular dyssynchrony achieved with carvedilol was higher than metoprolol (D interventricular delay at 6 months, 11 ± 8 ms to 6 ± 7 ms, p = 0.03). However, improvement in intraventricular dyssynchrony was similar in the two groups (D intraventricular delay, 9 ± 7 ms to 9 ± 6 ms, p = 0.91). Improvements in LV mechanical dyssynchrony and reverse remodeling achieved with both drugs were accompanied by reduction in NT-proBNP levels in both carvedilol and metoprolol groups (1614 ± 685 pg/mL to 654 ± ± 488 pg/mL and 1686 ± 730 pg/mL to 583 ± 396 pg/mL, respectively, p < 0.001 for both).

Conclusions: Although reduction in LVEDV and increase in LVEF was higher with carvedilol, improvement in intraventricular dyssynchrony was similar in carvedilol and metoprolol groups.

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Keywords

carvedilol, metoprolol succinate, intraventricular dyssynchrony, idiopathic dilated cardiomyopathy

About this article
Title

Evaluation of beta-blockers on left ventricular dyssynchrony and reverse remodeling in idiopathic dilated cardiomyopathy: A randomized trial of carvedilol and metoprolol

Journal

Cardiology Journal

Issue

Vol 21, No 4 (2014)

Pages

434-441

Published online

2014-08-29

DOI

10.5603/CJ.a2013.0149

Bibliographic record

Cardiol J 2014;21(4):434-441.

Keywords

carvedilol
metoprolol succinate
intraventricular dyssynchrony
idiopathic dilated cardiomyopathy

Authors

Mehmet Gungor Kaya
Bahadir Sarli
Mahmut Akpek
Esma Gunduz Kaya
Mikail Yarlioglues
Ramazan Topsakal
Yat-Yin Lam

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