© 2001 European Society of Cardiology
Influence of carvedilol on the benefits of physical training in patients with moderate chronic heart failure
a Centre de réadaptation cardiovasculaire Bois-Gibert 37510 Ballan-Miré, France
b Laboratoire de Biostatistique et d'Informatique médicale, CHU Bretonneau 37044 Tours Cedex 1, France
c Service de Cardiologie D/USCI, CHU Trousseau 37044 Tours Cedex 1, France
* Corresponding author. Tel.: +33-2-47-48-74-75; fax: +33-2-47-53-49-41 E-mail address: bgibert{at}club-internet.fr (J.F. Forissier).
 |
Abstract |
|---|
Aims: To evaluate prospectively the impact of carvedilol on a short-term physical training program in stable patients with moderate chronic heart failure (CHF), and to analyze parameters predictive of improvement after training.
Methods and results: Thirty-eight patients with CHF were referred for cardiac rehabilitation. Etiology was ischemic in 26 patients, dilated in 12 patients and left ventricular ejection fraction was < 35%. Patients were classified into three groups: group 1 (n = 14) = ACE inhibitors, diuretics and digitalis; group 2 (n = 11) = idem group 1+cardioselective beta-blocker; group 3 (n = 13) = idem group 1+carvedilol. Exercise tests with VO2 measurement were performed before and after a 4-week exercise training program. Patients with carvedilol experienced a 16.6% increase in peak VO2 which was similar to the 13.9% increase in the group with cardioselective beta-blocker and to the 18.5% in the group without beta-blocker. Moreover non-ischemic etiology of CHF was the only parameter predictive of improvement after training (P = 0.02).
Conclusions: Addition of carvedilol did not alter benefits of a short-term physical training program in patients with moderate CHF. No baseline characteristic except for etiology of CHF was predictive of a response to training.
Key Words: Carvedilol • Beta-blocker • Heart failure • Physical training • Cardiac rehabilitation
Received May 9, 2000; Revised September 15, 2000; Accepted November 30, 2000