Related Experiment Video

Updated: Aug 25, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Beta-blockade therapy in chronic heart failure: diastolic function and mitral regurgitation improvement by carvedilol

S Capomolla1, O Febo, M Gnemmi

  • 1"Salvatore Maugeri" Foundation, Institute of Medical Care and Research, Pavia, Italy. scapomolla@fsm.it

American Heart Journal
|March 31, 2000
PubMed

Insights

Carvedilol therapy improved heart function in chronic heart failure patients by reducing left ventricular dilation and mitral regurgitation. This beta-blocker therapy also enhanced diastolic reserve, improving overall patient outcomes.

Area of Science:

  • Cardiology
  • Pharmacology
  • Heart Failure Management

Background:

  • Chronic heart failure (CHF) is associated with impaired left ventricular (LV) function and increased mitral regurgitation (MR).
  • Carvedilol, a beta-blocker, is known to improve clinical and hemodynamic status in CHF patients.
  • Mechanisms of carvedilol's long-term effects on LV systolic and diastolic function, and MR remain unclear.

Purpose of the Study:

  • To investigate the effects of long-term carvedilol therapy on LV diastolic function and mitral regurgitation in CHF patients.
  • To assess changes in LV remodeling, including systolic function and dimensions, during carvedilol treatment.
  • To correlate changes in MR with forward stroke volume.

Main Methods:

  • A prospective study involving 45 CHF patients treated with carvedilol and a matched control group.
  • Patients had reduced ejection fraction (24% +/- 7%) due to ischemic or non-ischemic cardiomyopathy.
  • Echocardiographic and clinical variables were assessed at baseline and after 6 months of carvedilol therapy (mean dose 44 +/- 30 mg).

Main Results:

  • Carvedilol significantly increased LV ejection fraction (24% to 29%) and reduced end-systolic volume.
  • Deceleration time of early diastolic filling increased, indicating improved diastolic function, with some patients transitioning from restrictive to normal filling patterns.
  • Effective regurgitant orifice area and mitral regurgitant stroke volume significantly decreased in the carvedilol group, correlating with improved forward aortic stroke volume.

Conclusions:

  • Long-term carvedilol therapy prevents or reverses progressive LV dilatation in CHF patients.
  • Carvedilol treatment is associated with improved diastolic reserve and reduced mitral regurgitation, both significant prognostic predictors.
  • These findings elucidate the pathophysiologic mechanisms underlying carvedilol's benefits in managing chronic heart failure.
Abstract

More Related Videos

Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents07:26

Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents

Published on: July 14, 2021

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models07:49

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models

Published on: July 21, 2023

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Regurgitation IV: Nursing Management01:28

Mitral Regurgitation IV: Nursing Management

Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...