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Effects of carvedilol on left ventricular remodeling after acute myocardial infarction: the CAPRICORN Echo Substudy

Robert N Doughty1, Gillian A Whalley, Helen A Walsh

  • 1Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand. r.doughty@auckland.ac.nz

Circulation
|January 7, 2004
PubMed

Insights

Carvedilol reduced left ventricular end-systolic volume and improved ejection fraction in patients post-myocardial infarction. This ventricular remodeling benefit may explain carvedilol

Area of Science:

  • Cardiology
  • Pharmacology
  • Medical Imaging

Background:

  • The CAPRICORN trial demonstrated carvedilol's efficacy in patients with left ventricular dysfunction post-myocardial infarction (MI) when treated with ACE inhibitors.
  • This substudy investigated carvedilol's impact on left ventricular remodeling in this specific patient cohort.

Purpose of the Study:

  • To assess the effects of carvedilol on left ventricular remodeling.
  • To determine if changes in remodeling mediate clinical benefits.

Main Methods:

  • 127 patients from the CAPRICORN trial underwent quantitative 2D echocardiography.
  • Echocardiograms were performed at baseline and at 1, 3, and 6 months after treatment with carvedilol or placebo.
  • Left ventricular volumes, ejection fraction (Simpson's method), and wall motion score index were analyzed blindly.

Main Results:

  • At 6 months, carvedilol significantly reduced left ventricular end-systolic volume by 9.2 mL compared to placebo (P=0.023).
  • Left ventricular ejection fraction was significantly higher by 3.9% in the carvedilol group (P=0.015).
  • No significant differences were observed in left ventricular end-diastolic volume or wall motion score index between groups.

Conclusions:

  • Carvedilol demonstrated a beneficial effect on left ventricular remodeling in patients with left ventricular dysfunction post-MI treated with ACE inhibitors.
  • These remodeling improvements may partially explain the significant clinical benefits observed with carvedilol in this population.
Abstract

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