Related Experiment Video

Updated: Aug 15, 2026

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

Carvedilol improves myocardial contractility compared with metoprolol in patients with chronic hibernating myocardium

Ernst R Schwarz1, Rajiv Gupta, Tu Phuong Diep

  • 1Division of Cardiology, Department of Medicine, University of Texas Medical Branch, Galveston, TX 77555-0553, USA. erschwar@utmb.edu

Journal of Cardiovascular Pharmacology and Therapeutics
|October 8, 2005
PubMed

Insights

Carvedilol improved heart function after surgery for hibernating myocardium more than metoprolol tartrate. This may be due to reduced cardiomyocyte degeneration with carvedilol treatment.

Area of Science:

  • Cardiology
  • Pharmacology
  • Cardiac Surgery

Background:

  • Patients with hibernating myocardium experience progressive cellular degeneration and fibrosis.
  • Surgical revascularization is a common treatment for hibernating myocardium.

Purpose of the Study:

  • To compare the effects of carvedilol and metoprolol tartrate on functional recovery and morphologic degeneration in patients with hibernating myocardium undergoing surgical revascularization.

Main Methods:

  • Twenty patients with multivessel coronary artery disease and hibernating myocardium were randomized to receive carvedilol or metoprolol tartrate.
  • Left ventricular ejection fraction and regional wall motion were assessed preoperatively and 7 months postoperatively.
  • Intraoperative myocardial biopsies were analyzed for cardiomyocyte degeneration and fibrosis.

Main Results:

  • Carvedilol group showed greater improvement in ejection fraction (44% vs 40%) and wall motion (-0.6 vs -1.6).
  • Carvedilol treatment was associated with less cardiomyocyte degeneration (mild vs moderate) and similar fibrosis levels compared to metoprolol tartrate.
  • Apoptosis was minimal in both groups.

Conclusions:

  • Carvedilol enhances functional recovery after revascularization in hibernating myocardium compared to metoprolol tartrate.
  • Reduced cardiomyocyte degeneration may contribute to the improved outcomes observed with carvedilol.
Abstract

More Related Videos

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft05:25

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft

Published on: September 15, 2023

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine10:05

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine

Published on: July 7, 2016

Related Concept Videos

Adrenergic Antagonists: ɑ and β-Receptor Blockers01:31

Adrenergic Antagonists: ɑ and β-Receptor Blockers

Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is clinically...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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...
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...