© 2004 European Society of Cardiology
Effect of carvedilol on diastolic function in patients with diastolic heart failure and preserved systolic function. Results of the Swedish Doppler-echocardiographic study (SWEDIC)
a Department of Cardiology and Physiology, University Hospital Linköping SE-58185 Linköping, Sweden
b Department of Cardiology, Sahlgrenska University Hospital Göteborg, Sweden
c Section of Cardiology, Division of Internal Medicine, Karolinska Institutet, Danderyd Hospital Stockholm, Sweden
* Corresponding author. Tel.: +46-13-22-20-00. E-mail address: ulf.dahlstrom{at}lio.se
 |
Abstract |
|---|
Aim: The purpose of this study was to investigate the effects of carvedilol on diastolic function (DF) in heart failure patients with preserved left ventricular (LV) systolic function and abnormal DF.
Patients and Methods: We randomised 113 patients with diastolic heart failure (DHF) (symptomatic, with normal systolic LV function and abnormal DF) into a double blind multi-centre study. The patients received either carvedilol or matching placebo in addition to conventional treatment. After uptitration, treatment was continued for 6 months. Two-dimensional and Doppler echocardiography were used for quantification of LV function at baseline and at follow-up. Four different DF variables were evaluated by Doppler echocardiography: mitral flow E:A ratio, deceleration time (DT), isovolumic relaxation time (IVRT) and the ratio of systolic/diastolic pulmonary venous flow velocity (pv-S/D). Primary endpoint was change in the integrated quantitative assessment of all four variables during the study.
Results: Ninety-seven patients completed the study. A mitral flow pattern reflecting a relaxation abnormality was recorded in 95 patients. There was no effect on the primary endpoint, although a trend towards a better effect in carvedilol treated patients was noticed in patients with heart rates above 71 beats per minute. At the end of the study, there was a statistically significant improvement in E:A ratio in patients treated with carvedilol (0.72 to 0.83) vs. placebo (0.71 to 0.76), P<0.05.
Conclusions: Treatment with carvedilol resulted in a significant improvement in E:A ratio in patients with heart failure due to a LV relaxation abnormality. E:A ratio was found to be the most useful variable to identify diastolic dysfunction in this patient population. This effect was observed particularly in patients with higher heart rates at baseline.
Key Words: Diastolic heart failure • Carvedilol • Placebo-controlled • Non-invasive • E:A ratio
Received June 27, 2003; Revised December 22, 2003; Accepted February 5, 2004
For the SWEDIC investigators are listed in Appendix A.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  W. J. Paulus and J. J.M. van Ballegoij Treatment of Heart Failure With Normal Ejection Fraction: An Inconvenient Truth! J. Am. Coll. Cardiol., February 9, 2010; 55(6): 526 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Zhou, H. Shi, J. Zhang, Y. Lu, M. Fu, J. Ge, and for the ss-PRESERVE Study Investigators Rationale and design of the {beta}-blocker in heart failure with normal left ventricular ejection fraction ({beta}-PRESERVE) study Eur J Heart Fail, February 1, 2010; 12(2): 181 - 185. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Wachter, S. Schmidt-Schweda, D. Westermann, H. Post, F. Edelmann, M. Kasner, C. Luers, P. Steendijk, G. Hasenfuss, C. Tschope, et al. Blunted frequency-dependent upregulation of cardiac output is related to impaired relaxation in diastolic heart failure Eur. Heart J., December 2, 2009; 30(24): 3027 - 3036. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Hamdani, W. J. Paulus, L. van Heerebeek, A. Borbely, N. M. Boontje, M. J. Zuidwijk, J. G.F. Bronzwaer, W. S. Simonides, H. W. M. Niessen, G. J. M. Stienen, et al. Distinct myocardial effects of beta-blocker therapy in heart failure with normal and reduced left ventricular ejection fraction Eur. Heart J., August 1, 2009; 30(15): 1863 - 1872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. van Veldhuisen, A. Cohen-Solal, M. Bohm, S. D. Anker, D. Babalis, M. Roughton, A. J.S. Coats, P. A. Poole-Wilson, M. D. Flather, and SENIORS Investigators Beta-blockade with nebivolol in elderly heart failure patients with impaired and preserved left ventricular ejection fraction: Data From SENIORS (Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors With Heart Failure). J. Am. Coll. Cardiol., June 9, 2009; 53(23): 2150 - 2158. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. Alsaddique, A. G. Royse, C. F. Royse, and M. A. Fouda Management of diastolic heart failure following cardiac surgery Eur. J. Cardiothorac. Surg., February 1, 2009; 35(2): 241 - 249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Nishio, Y. Sakata, T. Mano, T. Ohtani, Y. Takeda, T. Miwa, M. Hori, T. Masuyama, T. Kondo, and K. Yamamoto Beneficial effects of bisoprolol on the survival of hypertensive diastolic heart failure model rats Eur J Heart Fail, May 1, 2008; 10(5): 446 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Th. Kremastinos, D. P. Tsiapras, A. G. Kostopoulou, E. S. Hamodraka, A. S. Chaidaroglou, and E. D. Kapsali NT-proBNP levels and diastolic dysfunction in {beta}-Thalassaemia major patients Eur J Heart Fail, May 1, 2007; 9(5): 531 - 536. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G.F. Cleland, P. H. Loh, N. Freemantle, A. L. Clark, and A. P. Coletta Clinical trials update from the European Society of Cardiology: SENIORS, ACES, PROVE-IT, ACTION, and the HF-ACTION trial Eur J Heart Fail, October 1, 2004; 6(6): 787 - 791. [Abstract] [Full Text] [PDF]
|
|