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Purpose: To compare the efficacy of nebivolol versus carvedilol on left ventricular(LV)function and exercise capacity in patients with nonischemic dilated cardiomyopathy(NIDC). Methods: After enrollment in this double-blind trial, 72 patients, aged 55±9.5 years, with NIDC, LV ejection fraction(LVEF)< 45%, New York Heart Association classes II to III, were randomized to either nebivolol(34 patients)or carvedilol(38 patients)and were evaluated through echocardiography and exercise tests at baseline and 3 and 12 months after treatment. Results: During follow-up, 4 patients discontinued nebivolol, although 3 patients stopped carve dilol. Patients in both the nebivolol and carvedilol groups showed a steady impr ovement in New York Heart Association class(P=.002 and< .001, at 12 months, resp ectively)and LVEF(P=.001 and< .001, at 12 months, respectively)that became signi ficant from 3-month follow-up on. Intergroup analysis showed that carvedilol g roup had a greater increase in LVEF at 3(P=.04)and 12(P=.02)months’follow-up c ompared with nebivolol group. Advanced diastolic dysfunction regressed to earlie r stages in carvedilol patients after 3(P=.02)and 12(P=.01)months’treatment, wh ereas in the nebivolol group, a significant improvement in diastolic dysfunction was found at the 12 months’follow-up(P=.02). Exercise duration improved in bo th groups at 12 months’follow-up(both P=.01), but in the nebivolol group, ther e was an initial deterioration at 3 months(P=.07). Conclusions: Both nebivolol a nd carvedilol appear relatively safe, with beneficial effects on LV systolic and diastolic function as well as exercise capacity in patients with NIDC after 12 months’treatment. However, carvedilol exhibits more favorable effects on LV fun ction than does nebivolol.
Purpose: To compare the efficacy of nebivolol versus carvedilol on left ventricular (LV) function and exercise capacity in patients with nonischemic dilated cardiomyopathy (NIDC). Methods: After enrollment in this double-blind trial, 72 patients, aged 55 ± 9.5 years, with NIDC, LV ejection fraction (LVEF) <45%, New York Heart Association classes II to III, were randomized to either nebivolol (34 patients) or carvedilol (38 patients) and were evaluated through echocardiography and exercise tests at baseline and 3 and 12 months after treatment. Results: During follow-up, 4 patients discontinued nebivolol, 3 patients stopped carve dilol. Patients in both the nebivolol and carvedilol groups showed a steady imprvement in New York Heart Association class (P = .002 and < .001, at 12 months, respctively) and LVEF (P = .001 and <.001, at 12 months, respectively) that became signi ficant from 3-month follow-up on. Intergroup analysis showed that carvedilol g roup had a greater increase in LVEF at 3 (P = .04) and 12 (P = .02) months’follow-up c ompared with nebivolol group. Advanced diastolic dysfunction regressed to earlie r stages in carvedilol patients after 3 (P = .02) and 12 (P = .01) months’treatment, wh ereas in the nebivolol group, a significant improvement in diastolic dysfunction was found at the 12 months’follow-up (P = .02). Exercise duration improved in bo th groups at 12 months’follow-up (both P = .01), but in the nebivolol group, ther e was an initial deterioration at 3 months (P = .07). Conclusions: Both nebivolol a nd carvedilol appear relatively safe, with beneficial effects on LV systolic and diastolic function as well as exercise capacity in patients with NIDC after 12 months’treatment. However, carvedilol exhibits more favorable effects on LV funtion than does nebivolol.