PMID- 14530474
OWN - NLM
STAT- MEDLINE
DCOM- 20031222
LR  - 20181130
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 44
IP  - 10
DP  - 2003 Oct
TI  - Efficacy of carvedilol treatment on cardiac function and cardiac sympathetic 
      nerve activity in patients with dilated cardiomyopathy: comparison with 
      metoprolol therapy.
PG  - 1604-11
AB  - Carvedilol and metoprolol have been reported to be effective in the treatment of 
      patients with chronic heart failure. However, to our knowledge, there have been 
      no studies comparing the effects of the 2 drugs on cardiac function, including 
      cardiac sympathetic nerve activity. METHODS: We compared 15 patients with dilated 
      cardiomyopathy (DCM) who were receiving carvedilol (group A) with 15 patients 
      with DCM who were receiving metoprolol (group B). Before and after 1 y of 
      treatment, cardiac (123)I-metaiodobenzylguanidine ((123)I-MIBG) uptake was 
      assessed using the total defect score (TDS) and the heart-to-mediastinum (H/M) 
      activity ratio from the delayed images. The New York Heart Association (NYHA) 
      class and echocardiographic left ventricular ejection fraction (LVEF) also were 
      assessed. RESULTS: In both groups, the TDS decreased (in group A, from 25 +/- 14 
      to 16 +/- 14, P < 0.01; in group B, from 27 +/- 9 to 19 +/- 10, P < 0.01), the 
      H/M increased (in group A, from 1.67 +/- 0.31 to 2.01 +/- 0.36, P < 0.01; in 
      group B, from 1.68 +/- 0.21 to 1.93 +/- 0.32, P < 0.01), the LVEF increased (in 
      group A, from 31% +/- 10% to 48% +/- 10%, P < 0.01; in group B, from 28% +/- 9% 
      to 47% +/- 15%, P < 0.01), and the NYHA functional class improved (in group A, 
      from 2.9 +/- 0.3 to 1.7 +/- 0.5, P < 0.01; in group B, from 2.8 +/- 0.6 to 1.7 
      +/- 0.6, P < 0.01). The change in LVEF was mildly correlated with the change in 
      the TDS in group A (r = 0.41) as well as in group B (r = 0.53). In the patients 
      with a favorable response in the TDS or H/M, the NYHA class improved more than in 
      the patients without a favorable response (P < 0.05). CONCLUSION: Carvedilol 
      treatment can improve cardiac function, symptoms, and cardiac sympathetic nerve 
      activity in patients with DCM to a similar extent as metoprolol treatment. The 
      improvement of cardiac function and symptoms is related to the improvement of 
      cardiac sympathetic nerve activity.
FAU - Toyama, Takuji
AU  - Toyama T
AD  - Gunma Prefectural Cardiovascular Center, Maebashi, Japan. 
      toyama.t@cvc.pref.gunma.jp
FAU - Hoshizaki, Hiroshi
AU  - Hoshizaki H
FAU - Seki, Ryotaro
AU  - Seki R
FAU - Isobe, Naoki
AU  - Isobe N
FAU - Adachi, Hitoshi
AU  - Adachi H
FAU - Naito, Shigeto
AU  - Naito S
FAU - Oshima, Shigeru
AU  - Oshima S
FAU - Taniguchi, Koichi
AU  - Taniguchi K
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (Adrenergic Antagonists)
RN  - 0 (Carbazoles)
RN  - 0 (Propanolamines)
RN  - 0 (Radiopharmaceuticals)
RN  - 0K47UL67F2 (Carvedilol)
RN  - 35MRW7B4AD (3-Iodobenzylguanidine)
RN  - 971Z4W1S09 (Technetium Tc 99m Sestamibi)
RN  - GEB06NHM23 (Metoprolol)
SB  - IM
MH  - 3-Iodobenzylguanidine
MH  - Adrenergic Antagonists/administration & dosage
MH  - Adult
MH  - Aged
MH  - Carbazoles/*administration & dosage
MH  - Cardiomyopathy, Dilated/complications/*diagnostic imaging/*drug therapy
MH  - Carvedilol
MH  - Female
MH  - Heart Ventricles/diagnostic imaging/drug effects/innervation
MH  - Humans
MH  - Male
MH  - Metoprolol/administration & dosage
MH  - Middle Aged
MH  - Propanolamines/*administration & dosage
MH  - Radionuclide Imaging
MH  - Radiopharmaceuticals
MH  - Sympathetic Nervous System/*diagnostic imaging/*drug effects
MH  - Technetium Tc 99m Sestamibi
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*diagnostic imaging/*drug therapy/etiology
EDAT- 2003/10/08 05:00
MHDA- 2003/12/23 05:00
CRDT- 2003/10/08 05:00
PHST- 2003/10/08 05:00 [pubmed]
PHST- 2003/12/23 05:00 [medline]
PHST- 2003/10/08 05:00 [entrez]
PST - ppublish
SO  - J Nucl Med. 2003 Oct;44(10):1604-11.