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Titolo:
Predicting response to carvedilol for the treatment of heart failure: A multivariate retrospective analysis
Autore:
Schleman, KA; Lindenfeld, JA; Lowes, BD; Bristow, MR; Ferguson, D; Wolfel, EE; Abraham, WT; Zisman, LS;
Indirizzi:
Albany Med Ctr, Heart Inst MC55, Albany, NY 12208 USA Albany Med Ctr Albany NY USA 12208 Heart Inst MC55, Albany, NY 12208 USA Univ Colorado, Hlth Sci Ctr, Denver, CO USA Univ Colorado Denver CO USAUniv Colorado, Hlth Sci Ctr, Denver, CO USA Univ Kentucky, Lexington, KY 40506 USA Univ Kentucky Lexington KY USA 40506 iv Kentucky, Lexington, KY 40506 USA
Titolo Testata:
JOURNAL OF CARDIAC FAILURE
fascicolo: 1, volume: 7, anno: 2001,
pagine: 4 - 12
SICI:
1071-9164(200103)7:1<4:PRTCFT>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
IDIOPATHIC DILATED CARDIOMYOPATHY; LEFT-VENTRICULAR FUNCTION; METOPROLOL; SURVIVAL; BLOCKADE;
Keywords:
beta-blocker; cardiomyopathy; myocardium;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Zisman, LS Albany Med Ctr, Heart Inst MC55, 47 New Scotland Ave, Albany, NY 12208 USA Albany Med Ctr 47 New Scotland Ave Albany NY USA 12208 2208 USA
Citazione:
K.A. Schleman et al., "Predicting response to carvedilol for the treatment of heart failure: A multivariate retrospective analysis", J CARD FAIL, 7(1), 2001, pp. 4-12

Abstract

Background: Carvedilol has been shown to decrease the progression of heartfailure and improve left ventricular function and survival in patients with a left ventricular ejection fraction (LVEF) less than 35%, However, not all patients respond uniformly to this therapy. We proposed to identify variables that could, potentially, be used to predict response to carvedilol therapy as measured by the change in LVEF after treatment (Delta LVEF), and to identify pretreatment variables associated with hospitalization for heartfailure after carvedilol therapy. Methods and Results: A retrospective analysis of 98 patients treated with open-label carvedilol for a mean period of 16 months was performed by usingbivariate and step-wise multivariate analyses. Bivariate analysis showed apositive correlation of Delta LVEF with heart rate at baseline (P = .001). There was a negative correlation of Delta LVEF with baseline LVEF (P < .01), diabetes mellitus (P = .04), and ischemic cardiomyopathy (P = .0002). Multivariate analysis showed a positive correlation of <Delta>LVEF with heartrate at baseline (P = .01) and a negative correlation with initial LVEF (P= .02) and ischemic cardiomyopathy (P = .006). Variables associated with hospitalization after initiation of carvedilol therapy were New York Heart Association (NYHA) classification (P = .001), lower extremity edema (P = .001), presence of an S3 (P = .02), hyponatremia (P = .02). elevated blood urea nitrogen (BUN) (P = .002), atrial fibrillation (P = .001), diabetes mellitus (P = .02), and obstructive sleep apnea (P = .009). Conclusions: Heart failure patients with the lowest LVEF or the highest heart rate at baseline had the greatest gain in LVEF after treatment with carvedilol. Patients with ischemic cardiomyopathy derived less benefit. Patients with clinical evidence of decompensated heart failure were at greater risk for hospitalization after initiation of carvedilol therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 06:19:00