PMID- 15864245
OWN - NLM
STAT- MEDLINE
DCOM- 20051031
LR  - 20220321
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 149
IP  - 3
DP  - 2005 Mar
TI  - Carvedilol therapy is associated with a sustained decline in brain natriuretic 
      peptide levels in patients with congestive heart failure.
PG  - 541-7
AB  - BACKGROUND: Beta-blocker therapy improves symptoms, left ventricular ejection 
      fraction (LVEF), and survival in patients with congestive heart failure, but 
      chronic effects on neurohormones have not been extensively investigated. 
      Therefore, we examined the neurohumoral effects of carvedilol. METHODS: 
      Fifty-five patients with New York Heart Association (NYHA) classes II-III 
      congestive heart failure and LVEF < or =35% entered the study with intention to 
      assess LVEF, NYHA class, plasma brain natriuretic peptide (BNP), N-terminal 
      atrial natriuretic peptide (NANP), big-endothelin, endothelin-1, norepinephrine, 
      and angiotensin II at baseline and at 6 and 12 months after initiation of 
      carvedilol. RESULTS: Forty-six patients completed 12 months of follow-up. Left 
      ventricular ejection fraction improved from 26% +/- 8% at baseline to 39% +/- 14% 
      at 12 months. New York Heart Association class improved from 2.3 +/- 0.4 at 
      baseline to 1.8 +/- 0.7 at 12 months. Brain natriuretic peptide fell from 453 +/- 
      784 to 208 +/- 393 pg/mL at 6 months and 223 +/- 334 pg/mL at 12 months ( P = .01 
      vs baseline). N-terminal atrial natriuretic peptide did not change between 
      baseline and 6 months but fell at 12 months (2117 +/- 1678, 2015 +/- 1532, and 
      1438 +/- 1442 pg/mL, respectively, P = .001 between baseline and 12 months). 
      Angiotensin II was lower at 6 and 12 months than at baseline (12.6 +/- 10, 7.8 
      +/- 5.5 pg/mL, P < 0.001, and 11.3 +/- 17.1 pg/mL, P = .02, respectively). Left 
      ventricular ejection fraction at 12 months correlated inversely with BNP level at 
      12 months (r = -0.55, P = .001). CONCLUSIONS: Carvedilol therapy is associated 
      with a sustained decline in BNP and NANP levels. Serial BNP levels can provide 
      some guidance regarding probability of LVEF improvement, but the relationship is 
      not strong enough for BNP levels to supplant measurement of LVEF.
FAU - Frantz, Robert P
AU  - Frantz RP
AD  - Division of Cardiovascular Diseases and Internal Medicine, Cardiorenal Research 
      Laboratories, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA. 
      frantz.robert@mayo.edu
FAU - Olson, Lyle J
AU  - Olson LJ
FAU - Grill, Diane
AU  - Grill D
FAU - Moualla, Soundos K
AU  - Moualla SK
FAU - Nelson, Susan M
AU  - Nelson SM
FAU - Nobrega, Thomas P
AU  - Nobrega TP
FAU - Hanna, Richard D
AU  - Hanna RD
FAU - Backes, Richard J
AU  - Backes RJ
FAU - Mookadam, Farouk
AU  - Mookadam F
FAU - Heublein, Denise
AU  - Heublein D
FAU - Bailey, Kent R
AU  - Bailey KR
FAU - Burnett, John C
AU  - Burnett JC
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Adrenergic alpha-Antagonists)
RN  - 0 (Biomarkers)
RN  - 0 (Carbazoles)
RN  - 0 (Endothelin-1)
RN  - 0 (Endothelins)
RN  - 0 (Propanolamines)
RN  - 0 (big-endothelin (1-22))
RN  - 0K47UL67F2 (Carvedilol)
RN  - 11128-99-7 (Angiotensin II)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Adrenergic alpha-Antagonists/*pharmacology/therapeutic use
MH  - Angiotensin II/metabolism
MH  - Atrial Natriuretic Factor/*metabolism
MH  - Biomarkers/metabolism
MH  - Carbazoles/*pharmacology/therapeutic use
MH  - Carvedilol
MH  - Endothelin-1/metabolism
MH  - Endothelins/metabolism
MH  - Female
MH  - Heart Failure/*drug therapy/*metabolism
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/drug effects/*metabolism
MH  - Propanolamines/*pharmacology/therapeutic use
EDAT- 2005/05/03 09:00
MHDA- 2005/11/01 09:00
CRDT- 2005/05/03 09:00
PHST- 2005/05/03 09:00 [pubmed]
PHST- 2005/11/01 09:00 [medline]
PHST- 2005/05/03 09:00 [entrez]
AID - S0002870304005940 [pii]
AID - 10.1016/j.ahj.2004.07.036 [doi]
PST - ppublish
SO  - Am Heart J. 2005 Mar;149(3):541-7. doi: 10.1016/j.ahj.2004.07.036.