Effects of carvedilol on left ventricular remodeling after acute myocardial infarction: The CAPRICORN Echo substudy

• Published in: Circulation (New York, N.Y.) N.Y.), 2004-01, Vol.109 (2), p.201-206
• Main Authors: DOUGHTY, Robert N, WHALLEY, Gillian A, WALSH, Helen A, GAMBLE, Greg D, LOPEZ-SENDON, José, SHARPE, Norman
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - drug effects; Carbazoles - therapeutic use; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Heart Rate - drug effects; Humans; Kinetics; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - drug therapy; Myocardial Infarction - physiopathology; Propanolamines - therapeutic use; Ultrasonography; Ventricular Remodeling - drug effects
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.0000108928.25690.94

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. 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. 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.