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Published on: December 11, 2017

Effect of carvedilol on heart failure in patients with a functionally univentricular heart

Naoko Ishibashi1, In-Sam Park, Tadashi Waragai

  • 1Department of Pediatrics, Sakakibara Heart Institute, Tokyo, Japan.

Circulation Journal : Official Journal of the Japanese Circulation Society
|March 26, 2011
PubMed

Insights

Carvedilol effectively treats heart failure (HF) in patients with a functionally univentricular heart (UVH). This study shows improved heart function and reduced medication needs in UVH patients receiving carvedilol therapy.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • The efficacy of carvedilol for heart failure (HF) in patients with a functionally univentricular heart (UVH) is not well-established.
  • Univentricular heart physiology presents unique challenges in managing heart failure.

Purpose of the Study:

  • To evaluate the effects of carvedilol on heart failure in patients with a functionally univentricular heart.
  • To assess changes in cardiac function, clinical status, and medication requirements.

Main Methods:

  • A cohort of 51 patients with UVH, stratified into three groups (post-Fontan, post-Glenn, and pre-surgical), received carvedilol therapy.
  • Dosage adjustments were made, with initial and maximum mean doses of 0.04 ± 0.03 and 0.42 ± 0.29 mg·kg⁻¹·day⁻¹, respectively.
  • Follow-up included assessment of cardiothoracic ratio, furosemide dosage, ejection fraction, and clinical symptoms.

Main Results:

  • Carvedilol treatment led to a significant improvement in the cardiothoracic ratio (60 ± 8% to 58 ± 8%, P<0.01) and a reduction in furosemide dosage (1.4 ± 0.9 to 0.7 ± 0.7 mg·kg⁻¹·day⁻¹, P<0.01).
  • Ejection fraction improved from 35 ± 12% to 40 ± 11% (P<0.05), with a more pronounced effect observed in the post-Fontan group (35 ± 15% to 45 ± 9%, P<0.05).
  • Significant improvements were noted in clinical signs, symptoms, and New York Heart Association functional class.

Conclusions:

  • Carvedilol demonstrates a significant role in managing heart failure associated with a functionally univentricular heart.
  • The findings suggest carvedilol is a beneficial therapeutic option for this complex patient population.
Abstract

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