BACKGROUND: The long-term effects of carvedilol on muscle sympathetic nerve activity (MSNA) and muscle blood flow at rest and exercise in patients with chronic heart failure (CHF) remain unknown. METHODS AND RESULTS:Twenty-six patients (New York Heart Association class II-III) were randomized to carvedilol or placebo. Blood pressure, heart rate, MSNA, and forearm vascular resistance (FVR) at rest and during isometric forearm exercise (10% and 30% maximal voluntary contraction) were assessed before and after 6 months. Seven patients did not complete the study. Paired data were obtained in 19 (carvedilol 12, placebo 7). Carvedilol significantly decreased MSNA levels and heart rate at rest (-13 +/- 2 versus 3 +/- 8 bursts/min, P = .0001 and -16 +/- 3 vs -4 +/- 6 bpm, P = .05, respectively) and peak exercise (30% = -20 +/- 5 versus -3 +/- 7 bursts/min, P = 0.05 and -19 +/- 4 versus -4 +/- 6 bpm, P = 0.03, respectively) when compared with placebo. Carvedilol did not change a magnitude of response of MSNA and heart rate during exercise (-10 +/- 3 versus -7 +/- 2 bursts/min, P = 0.7 and 11 +/- 3 versus 6 +/- 1, P = .6, respectively). FVR was unchanged by carvedilol. When MSNA was quantified by burst incidence, the strength of reduction in MSNA was attenuated but still greater than placebo. CONCLUSIONS:Carvedilol reduces MSNA in patients with CHF. Carvedilol does not reduce FVR at rest or during isometric exercise.
RCT Entities:
BACKGROUND: The long-term effects of carvedilol on muscle sympathetic nerve activity (MSNA) and muscle blood flow at rest and exercise in patients with chronic heart failure (CHF) remain unknown. METHODS AND RESULTS: Twenty-six patients (New York Heart Association class II-III) were randomized to carvedilol or placebo. Blood pressure, heart rate, MSNA, and forearm vascular resistance (FVR) at rest and during isometric forearm exercise (10% and 30% maximal voluntary contraction) were assessed before and after 6 months. Seven patients did not complete the study. Paired data were obtained in 19 (carvedilol 12, placebo 7). Carvedilol significantly decreased MSNA levels and heart rate at rest (-13 +/- 2 versus 3 +/- 8 bursts/min, P = .0001 and -16 +/- 3 vs -4 +/- 6 bpm, P = .05, respectively) and peak exercise (30% = -20 +/- 5 versus -3 +/- 7 bursts/min, P = 0.05 and -19 +/- 4 versus -4 +/- 6 bpm, P = 0.03, respectively) when compared with placebo. Carvedilol did not change a magnitude of response of MSNA and heart rate during exercise (-10 +/- 3 versus -7 +/- 2 bursts/min, P = 0.7 and 11 +/- 3 versus 6 +/- 1, P = .6, respectively). FVR was unchanged by carvedilol. When MSNA was quantified by burst incidence, the strength of reduction in MSNA was attenuated but still greater than placebo. CONCLUSIONS:Carvedilol reduces MSNA in patients with CHF. Carvedilol does not reduce FVR at rest or during isometric exercise.
Authors: Linda M Ueno; Luciano F Drager; Ana C T Rodrigues; Maria U P B Rondon; Ana M F W Braga; Wilson Mathias; Eduardo M Krieger; Antonio C P Barretto; Holly R Middlekauff; Geraldo Lorenzi-Filho; Carlos E Negrão Journal: Sleep Date: 2009-05 Impact factor: 5.849
Authors: Shekhar H Deo; James P Fisher; Lauro C Vianna; Areum Kim; Anand Chockalingam; Matthew C Zimmerman; Irving H Zucker; Paul J Fadel Journal: Am J Physiol Heart Circ Physiol Date: 2012-06-01 Impact factor: 4.733
Authors: Andréa S Vanzelli; Alessandra Medeiros; Natale Rolim; Jan B Bartholomeu; Telma F Cunha; Luiz R G Bechara; Luiz G Bechara; Enéas R M Gomes; Katt C Mattos; Raquel Sirvente; Vera Maria Cury Salemi; Vera Salemi; Charles Mady; Carlos E Negrao; Silvia Guatimosim; Patricia C Brum Journal: PLoS One Date: 2013-05-01 Impact factor: 3.240
Authors: Kanokwan Bunsawat; Stephen M Ratchford; Jeremy K Alpenglow; Josef Stehlik; Adam S Smith; Russell S Richardson; D Walter Wray Journal: Auton Neurosci Date: 2021-06-24 Impact factor: 2.355
Authors: Marc Labrunée; Fabien Despas; Philippe Marque; Thibaut Guiraud; Michel Galinier; Jean Michel Senard; Atul Pathak Journal: PLoS One Date: 2013-11-12 Impact factor: 3.240