gms | German Medical Science

33. Internationale Konferenz für Elektrokardiographie

Internationale Konferenz für Elektrokardiographie

Beneficial effects of carvedilol and enalapril treatment on electrical and structural remodeling and mortality in chronic heart failure

Meeting Abstract

  • corresponding author presenting/speaker V.V. Popov - Moscow University of Medicine and Dentistry, Moscow, Russland
  • N.A. Bulanova - Educational Research Medical Center, Moscow, Russland
  • N.P. Kopitsa - Research institute of Therapy of AMS of Ukraine, Kharkov, Ukraine
  • A.E. Radzevich - Moscow University of Medicine and Dentistry, Moscow, Russland

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice057

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Veröffentlicht: 8. Februar 2007

© 2007 Popov et al.
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Question: The aim of the study was to assess the effects of carvedilol therapy in addition to conventional heart failure therapy on heart rate variability (HRV) and on electrical and structural remodeling.

Methods used: In a prospective study powered for mortality, we recruited 112 outpatients 56 ± 12 years old with chronic heart failure (CHF - NYHA functional class II to III; mean ejection fraction, 47,8 ± 17,6. Patients receiving conventional treatment for heart failure were randomly assigned to receive either enalapril (6) or carvedilol ( 35) or carvedilol plus enalapril (n = 26 ). Echocardiographic, signal-averaged electrocardiography , HRV indices, ECG and clinical data were recorded.

Results: During 12 month of follow-up, SDNN, left ventricular end-systolic diameter, SAQRS , QTc and QTc-max were significant predictors of all-cause mortality. After 3 months, the patients receiving carvedilol plus enalapril had a reduced mean heart rate , compared with the baseline data (p < 0.05 ), increased SDNN (p<0.05) and decreased QTc and QT cd (p < 0.05 ). Treatment with carvedilol and enalapril improved both hemodynamic and clinical parameters: left ventricular ejection fraction increased from 47,8 ± 17,6 % to 62,8 ± 10,8 (p<0.05), and New York Heart Association class decreased (p<0.05).

Conclusions: Autonomic dysfunction, electrical structural remodeling may play an important role in the pathophysiology of cardiac death in CHF. The long-term beta-blockade strategy with carvedilol is strongly recommended to reduce the rates of mortality and morbidity in patients with CHF.