The role of carvedilol in the treatment of heart failure (CROSBI ID 546295)
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Podaci o odgovornosti
Zaputović, Luka
engleski
The role of carvedilol in the treatment of heart failure
Sympathetic hyperactivity in heart failure patients with enhanced stimulation of b1, b2 and a1 adrenergic receptors exerts many deleterious effects on cardiovascular system and kidneys, inducing vasoconstriction, sodium retention, myocardial hypertrophy, apoptosis, remodelling, ischemia and arrhythmia. Metoprolol, bisoprolol and carvedilol, beta blockers shown to be effective in the treatment of patients with heart failure, differ substantially in their pharmacological properties. Carvedilol is the only one that blocks all three types of adrenergic receptors, and to exhibit antioxidant and antiproliferative action in addition. The important question in antiadrenergic therapy of heart failure is wether these pharmacological differences among beta blockers are clinically relevant. To answer this question short-term effects (i.e., rate of worsening heart failure when therapy is initiated), and long-term effects (i.e., outcome, efficacy in special populations, influence on left ventricular function and hemodynamics, effective doses, tolerability) have to be analyzed. Concerning all mentioned, and based on published data, especially the results of comparative trials, carvedilol has been shown to be superior to other beta blockers effective in heart failure. Carvedilol is the only drug with beta blocking activity that provides comprehensive adrenergic blockade. It is more beneficial than conventional beta blocking agents in mild to moderate heart failure and the only beta blocker proven to be effective at lower doses. The COPERNICUS trial with carvedilol enrolled the most severely affected heart failure population than any trial of beta blockade before. Carvedilol significantly reduced morbidity and mortality, and was well tolerated. Based on the results of clinical trials with beta blockade achived by carvedilol is better than selective one.
Heart failure; Treatment; Beta blockers; Carvedilol
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Podaci o prilogu
15-15.
2001.
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objavljeno
Podaci o matičnoj publikaciji
Acta clinica Croatica
Zagreb:
0353-9466
Podaci o skupu
9th Alpe Adria Cardiology Meeting
ostalo
06.06.2001-09.06.2001
Cavtat, Hrvatska