Circulation. 2004;109:201-206
Published online before print January 5, 2004, doi: 10.1161/01.CIR.0000108928.25690.94
Published online before print January 5, 2004, doi: 10.1161/01.CIR.0000108928.25690.94
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(Circulation. 2004;109:201-206.)
© 2004 American Heart Association, Inc.
Clinical Investigation and Reports |
Effects of Carvedilol on Left Ventricular Remodeling After Acute Myocardial Infarction
The CAPRICORN Echo Substudy
From the Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand, and Hospital Gregorio Maranon (J.L.-S.), Madrid, Spain.
Correspondence to Dr R.N. Doughty, Senior Lecturer in Cardiology, Department of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand. E-mail r.doughty{at}auckland.ac.nz
Received June 18, 2003; revision received October 6, 2003; accepted October 6, 2003.
Background— The CAPRICORN trial has shown that carvedilol improved outcome in patients with left ventricular dysfunction after acute myocardial infarction treated with ACE inhibitors. The aim of this substudy was to determine the effects of carvedilol on left ventricular remodeling in this patient group.
Methods and Results— Patients entering the CAPRICORN trial from 13 centers in New Zealand, Australia, and Spain were recruited for this echocardiographic substudy. In 127 patients, quantitative 2D echocardiography was performed according to a standard protocol before randomization and repeated after 1, 3, and 6 months of treatment with carvedilol or placebo. Left ventricular volumes, ejection fraction (Simpson’s method), and wall motion score index were determined in a blinded analysis at the Core Echo Laboratory. At 6 months, left ventricular end systolic volume was 9.2 mL less in the carvedilol group than in the placebo group (P=0.023), and left ventricular ejection fraction was 3.9% higher (P=0.015). Left ventricular end diastolic volume and wall motion score index were not statistically different between the 2 groups at 6 months.
Conclusions— In patients with left ventricular dysfunction after acute myocardial infarction treated with ACE inhibitors, carvedilol had a beneficial effect on ventricular remodeling, which may, in part, mediate the substantial clinical beneficial effects of carvedilol in this patient population.
Key Words: remodeling • infarction • ventricles • echocardiography
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