PMID- 11264544
OWN - NLM
STAT- MEDLINE
DCOM- 20010521
LR  - 20181130
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 7
IP  - 1
DP  - 2001 Mar
TI  - Predicting response to carvedilol for the treatment of heart failure: a 
      multivariate retrospective analysis.
PG  - 4-12
AB  - BACKGROUND: Carvedilol has been shown to decrease the progression of heart 
      failure and improve left ventricular function and survival in patients with a 
      left ventricular ejection fraction (LVEF) less than 35%. However, not all 
      patients respond uniformly to this therapy. We proposed to identify variables 
      that could, potentially, be used to predict response to carvedilol therapy as 
      measured by the change in LVEF after treatment (Delta LVEF), and to identify 
      pretreatment variables associated with hospitalization for heart failure after 
      carvedilol therapy. METHODS AND RESULTS: A retrospective analysis of 98 patients 
      treated with open-label carvedilol for a mean period of 16 months was performed 
      by using bivariate and step-wise multivariate analyses. Bivariate analysis showed 
      a positive correlation of Delta LVEF with heart rate at baseline (P =.001). There 
      was a negative correlation of Delta LVEF with baseline LVEF (P <.01), diabetes 
      mellitus (P =.04), and ischemic cardiomyopathy (P =.0002). Multivariate analysis 
      showed a positive correlation of Delta LVEF with heart rate at baseline (P =.01) 
      and a negative correlation with initial LVEF (P =.02) and ischemic cardiomyopathy 
      (P =.006). Variables associated with hospitalization after initiation of 
      carvedilol therapy were New York Heart Association (NYHA) classification (P 
      =.001), lower extremity edema (P =.001), presence of an S3 (P =.02), hyponatremia 
      (P =.02), elevated blood urea nitrogen (BUN) (P =.002), atrial fibrillation (P 
      =.001), diabetes mellitus (P =.02), and obstructive sleep apnea (P =.009). 
      CONCLUSIONS: Heart failure patients with the lowest LVEF or the highest heart 
      rate at baseline had the greatest gain in LVEF after treatment with carvedilol. 
      Patients with ischemic cardiomyopathy derived less benefit. Patients with 
      clinical evidence of decompensated heart failure were at greater risk for 
      hospitalization after initiation of carvedilol therapy.
FAU - Schleman, K A
AU  - Schleman KA
AD  - University of Colorado Health Sciences Center, Denver, Colorado, USA.
FAU - Lindenfeld, J A
AU  - Lindenfeld JA
FAU - Lowes, B D
AU  - Lowes BD
FAU - Bristow, M R
AU  - Bristow MR
FAU - Ferguson, D
AU  - Ferguson D
FAU - Wolfel, E E
AU  - Wolfel EE
FAU - Abraham, W T
AU  - Abraham WT
FAU - Zisman, L S
AU  - Zisman LS
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Carbazoles)
RN  - 0 (Propanolamines)
RN  - 0 (Vasodilator Agents)
RN  - 0K47UL67F2 (Carvedilol)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carbazoles/*therapeutic use
MH  - Carvedilol
MH  - Female
MH  - Follow-Up Studies
MH  - Gated Blood-Pool Imaging/drug effects
MH  - Heart Failure/*drug therapy
MH  - Heart Rate/drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Propanolamines/*therapeutic use
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume/drug effects
MH  - Treatment Outcome
MH  - Vasodilator Agents/*therapeutic use
MH  - Ventricular Function, Left/drug effects
EDAT- 2001/03/27 10:00
MHDA- 2001/05/25 10:01
CRDT- 2001/03/27 10:00
PHST- 2001/03/27 10:00 [pubmed]
PHST- 2001/05/25 10:01 [medline]
PHST- 2001/03/27 10:00 [entrez]
AID - S1071-9164(01)38933-9 [pii]
AID - 10.1054/jcaf.2001.22491 [doi]
PST - ppublish
SO  - J Card Fail. 2001 Mar;7(1):4-12. doi: 10.1054/jcaf.2001.22491.