Artigo Produção Nacional Revisado por pares

Impact of 6 months of therapy with carvedilol on muscle sympathetic nerve activity in heart failure patients

2004; Elsevier BV; Volume: 10; Issue: 6 Linguagem: Inglês

10.1016/j.cardfail.2004.03.006

ISSN

1532-8414

Autores

Luciana Diniz Nagem Janot de Matos, Giulliano Gardenghi, Maria Urbana Pinto Brandão Rondon, Helena Nogueira Soufen, A Tirone, Antônio Carlos Pereira Barretto, Patrı́cia C. Brum, Holly R. Middlekauff, Carlos Eduardo Negrão,

Tópico(s)

Cardiac Health and Mental Health

Resumo

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.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.Carvedilol reduces MSNA in patients with CHF. Carvedilol does not reduce FVR at rest or during isometric exercise.

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