PMID- 14692707
OWN - NLM
STAT- MEDLINE
DCOM- 20040323
LR  - 20190607
IS  - 0946-1965 (Print)
IS  - 0946-1965 (Linking)
VI  - 41
IP  - 12
DP  - 2003 Dec
TI  - Serum carvedilol concentration and its relation to change in plasma brain 
      natriuretic peptide level in the treatment of heart failure: a preliminary study.
PG  - 578-86
AB  - OBJECTIVE: To examine the influence of carvedilol dose and concentration in serum 
      on plasma brain natriuretic peptide (BNP), a measure of heart failure 
      progression. METHODS: 12 patients with New York Heart Association (NYHA) 
      functional class II-III chronic heart failure were enrolled in the study. They 
      received carvedilol at daily doses of 1-20 mg with a 1-2 weekly adjustment. Serum 
      carvedilol trough concentrations were measured in steady-state using a specific 
      fluorescence HPLC method. The degree of improvement in heart failure was assessed 
      from the ratio of change in the plasma BNP concentration, 2 weeks, 1 month and 3 
      months after the commencement of carvedilol administration. RESULTS: From the 
      pharmacokinetic aspect, there was no valid correlation between the trough serum 
      carvedilol concentration (Cmin) and daily dose per body weight (Dd/BW), 
      indicating that there was a wide difference in the carvedilol elimination 
      capacity among individuals. A significant decrease in the BNP was observed at the 
      3rd month in patients treated with the high dose (> 750 mg/3 months). On the 
      other hand, in patients with a mean serum carvedilol level (Cmin) of less than 
      2.5 nmol/l up to 2 weeks after the start ofcarvedilol therapy, the degree of 
      reduction in the BNP value after the 3rd month was significantly larger, relative 
      to the patient group with Cmin over 2.5 nmol/l. CONCLUSIONS: The total carvedilol 
      dose was confirmed to be one of the determinants for improvement in heart 
      failure, and it was suggested that the initial serum level also plays an 
      important role in therapeutic outcome. Therefore, it may be important to monitor 
      the serum carvedilol level at the introductory period to determine the daily dose 
      requirements because of the wide inter-individual variability in its metabolic 
      clearance.
FAU - Konishi, H
AU  - Konishi H
AD  - Department of Hospital Pharmacy, Shiga University of Medical Science, Seta, Otsu, 
      Japan. konishi@belle.shiga-med.ac.jp
FAU - Nishio, S
AU  - Nishio S
FAU - Tsutamoto, T
AU  - Tsutamoto T
FAU - Minouchi, T
AU  - Minouchi T
FAU - Yamaji, A
AU  - Yamaji A
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - Germany
TA  - Int J Clin Pharmacol Ther
JT  - International journal of clinical pharmacology and therapeutics
JID - 9423309
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Carbazoles)
RN  - 0 (Propanolamines)
RN  - 0K47UL67F2 (Carvedilol)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adrenergic beta-Antagonists/*blood/*pharmacology
MH  - Adult
MH  - Aged
MH  - Carbazoles/*blood/*pharmacology
MH  - Carvedilol
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*analysis
MH  - Propanolamines/*blood/*pharmacology
MH  - Reproducibility of Results
MH  - Treatment Outcome
EDAT- 2003/12/25 05:00
MHDA- 2004/03/24 05:00
CRDT- 2003/12/25 05:00
PHST- 2003/12/25 05:00 [pubmed]
PHST- 2004/03/24 05:00 [medline]
PHST- 2003/12/25 05:00 [entrez]
AID - 10.5414/cpp41578 [doi]
PST - ppublish
SO  - Int J Clin Pharmacol Ther. 2003 Dec;41(12):578-86. doi: 10.5414/cpp41578.