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Long-term effects of carvedilol or metoprolol on left ventricular function in ischemic and nonischemic cardiomyopathy

Philip Green1, Michael Anshelevich, Ashok Talreja

  • 1Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461, USA.

The American Journal of Cardiology
|April 22, 2005
PubMed

Insights

Beta blockers like carvedilol and metoprolol significantly improve left ventricular (LV) function in cardiomyopathy patients. These benefits are sustained long-term, especially in those without major clinical events.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Limited data exists on long-term beta-blocker effects on left ventricular (LV) function in ischemic and nonischemic cardiomyopathy.
  • Beta-blockers are standard therapy for heart failure, but their sustained impact on LV function requires further elucidation.

Purpose of the Study:

  • To evaluate the long-term effects of carvedilol or metoprolol on LV function in patients with ischemic and nonischemic cardiomyopathy.
  • To determine if initial improvements in LV ejection fraction (EF) predict sustained benefits.

Main Methods:

  • Prospective reanalysis of echocardiograms from 72 patients with cardiomyopathy receiving carvedilol or metoprolol for at least 24 months.
  • Patients were stratified based on LV ejection fraction (EF) changes (> or = 5% increase vs. <5% increase or decrease) at 12 months.

Main Results:

  • After 12 months, 75% of patients showed an LV ejection fraction (EF) increase of > or = 5%.
  • Patients with an initial EF increase (> or = 5%) experienced further improvement over the next 32 months.
  • Patients with an initial EF increase of <5% or a decrease showed a trend towards further decline in EF.

Conclusions:

  • Carvedilol and metoprolol demonstrate long-lasting benefits on LV function in patients with ischemic or nonischemic cardiomyopathy.
  • Sustained improvement in LV function is associated with an initial positive response to beta-blocker therapy.
  • Maintaining beta-blocker treatment in event-free cardiomyopathy patients preserves and enhances LV function over time.

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