Cardiology · 2010
Therapeutic window for calcium-channel blockers in the management of dilated cardiomyopathy: a prospective, two-centre study on non-advanced disease.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Wojnicz Romuald, Nowak Jolanta, Lekston Andrzej, Wilczewski Przemysław, Nowalany-Kozielska Ewa, Streb Witold, Wojciechowska Celina, Stolarz Wojciech, Helewski Krzysztof, Szyguła-Jurkiewicz Bożena, Poloński Lech
Аннотация
OBJECTIVE: This study aimed to investigate the usefulness of the calcium-channel blocker verapamil in non-advanced dilated cardiomyopathy (DCM).
METHODS: This was a randomised trial of 70 DCM patients treated with carvedilol (36 patients) and verapamil (instead of β-blocker; 34 patients) for 12 months. The remaining heart failure (HF) therapy was constant in both groups. The primary outcomes were to determine selected echocardiography parameters and functional status of patients. The secondary outcome included death, heart transplantation and re-hospitalisation due to HF progression.
RESULTS: Of the primary outcomes, only the mean ratio of early to late transmitral flow velocities increased significantly in the verapamil-treated patients as compared with the carvedilol-based therapy (1.1 ± 0.3 vs. 0.7 ± 0.2; 95% CI -0.6 to -0.1; p = 0.015). Simultaneously, the Minnesota Quality of Life improved significantly in the verapamil group (95% CI 5.2-19.9; p = 0.002). It was accompanied by the favourable effect of verapamil therapy on exercise capacity in the 6-min walk test (95% CI 21.3-110.7; p = 0.005).
CONCLUSION: The addition of verapamil to angiotensin-converting enzyme and aldosterone inhibitors in non-advanced DCM patients has been shown to have a neutral or even positive effect in a few patients.
METHODS: This was a randomised trial of 70 DCM patients treated with carvedilol (36 patients) and verapamil (instead of β-blocker; 34 patients) for 12 months. The remaining heart failure (HF) therapy was constant in both groups. The primary outcomes were to determine selected echocardiography parameters and functional status of patients. The secondary outcome included death, heart transplantation and re-hospitalisation due to HF progression.
RESULTS: Of the primary outcomes, only the mean ratio of early to late transmitral flow velocities increased significantly in the verapamil-treated patients as compared with the carvedilol-based therapy (1.1 ± 0.3 vs. 0.7 ± 0.2; 95% CI -0.6 to -0.1; p = 0.015). Simultaneously, the Minnesota Quality of Life improved significantly in the verapamil group (95% CI 5.2-19.9; p = 0.002). It was accompanied by the favourable effect of verapamil therapy on exercise capacity in the 6-min walk test (95% CI 21.3-110.7; p = 0.005).
CONCLUSION: The addition of verapamil to angiotensin-converting enzyme and aldosterone inhibitors in non-advanced DCM patients has been shown to have a neutral or even positive effect in a few patients.
Предметные рубрики MeSH
AdultAngiotensin-Converting Enzyme InhibitorsBlood Flow VelocityCalcium Channel BlockersCarbazolesCardiomyopathy, DilatedCarvedilolDiastoleDrug Therapy, CombinationExercise ToleranceFemaleHumansMaleMiddle AgedMineralocorticoid Receptor AntagonistsMitral ValvePropanolaminesProspective StudiesSeverity of Illness IndexVasodilator AgentsVentricular Function, LeftVerapamil