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Predictors of improvement in left ventricular ejection fraction with carvedilol for congestive heart failure

J H O'Keefe1, A Magalski, T L Stevens

  • 1Mid America Heart Institute, St Luke's Hospital, Kansas City, MO, USA.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|March 4, 2000
PubMed

Insights

Carvedilol significantly improved left ventricular ejection fraction (LVEF) in patients with congestive heart failure (CHF). Nonischemic cardiomyopathy and recent CHF onset predicted greater LVEF improvement with beta-blocker therapy.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Beta-blocker therapy is known to improve survival and LVEF in congestive heart failure (CHF).
  • The extent and predictors of LVEF improvement with beta-blockers remain unclear.

Purpose of the Study:

  • To evaluate the magnitude and identify predictors of LVEF improvement in patients with CHF treated with carvedilol.

Main Methods:

  • 295 patients with symptomatic CHF and LVEF <35% were enrolled.
  • Carvedilol was initiated and titrated to 25 or 50 mg twice daily.
  • Paired LVEFs were assessed at baseline and 9 months in 161 patients.

Main Results:

  • LVEF improved significantly from 25% to 36% (P<.001).
  • Greater LVEF improvement was observed in nonischemic cardiomyopathy (NICM) compared to ischemic cardiomyopathy.
  • NICM and recent CHF onset were identified as correlates of improved LVEF.

Conclusions:

  • Carvedilol significantly enhances LVEF in patients with CHF.
  • Nonischemic cardiomyopathy and recent onset of CHF are associated with greater LVEF improvement.
Abstract

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