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[Acute hemodynamic effects of the vasodilator beta blocker carvedilol in heart failure]

A Buchwald1, C Unterberg, R van der Does

  • 1Abteilung Kardiologie und Pulmonologie, Universitätsklinik Göttingen.

Zeitschrift Fur Kardiologie
|June 1, 1990
PubMed

Insights

Intravenous carvedilol did not show an acute vasodilating effect in heart failure patients. The drug did not decrease blood pressure or peripheral resistance, contrary to expectations for vasodilation.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Carvedilol, a beta-blocker, is known to induce vasodilation in coronary artery disease patients.
  • Heart failure is often associated with altered hemodynamics and reduced cardiac function.

Purpose of the Study:

  • To investigate the acute vasodilating effect of intravenous carvedilol in patients with heart failure.
  • To assess the impact of carvedilol on hemodynamic parameters during exercise in heart failure.

Main Methods:

  • A double-blind, randomized, placebo-controlled, cross-over study.
  • Inclusion of patients with coronary artery disease and dilated cardiomyopathy (ejection fraction < 40%).
  • Measurement of rate-pressure-product, heart rate, blood pressure, and total peripheral resistance via Swan-Ganz catheterization and supine ergometry.

Main Results:

  • Intravenous carvedilol (5 mg) did not significantly alter blood pressure compared to placebo.
  • Heart rate was lower at rest and during exercise with carvedilol.
  • Total peripheral resistance during exercise was higher with carvedilol, particularly in the coronary artery disease group.

Conclusions:

  • Acute intravenous administration of carvedilol does not demonstrate a vasodilating effect in patients with heart failure.
  • The observed effects on heart rate and peripheral resistance suggest a different hemodynamic profile than anticipated vasodilation.

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