Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2007; 35(5): 284-288

Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure

Serdar Sevimli, Şakir Arslan, Fuat Gündoğdu, Enbiya Aksakal, Hakan Taş, Yekta Gürlertop, Hüseyin Şenocak, Sebahattin Ateşal, Necip Alp
Department Of Cardiology, Ataturk University, Medical School Hospital, Erzurum, Turkey


OBJECTIVES
We investigated the effect of carvedilol on corrected QT dispersion (QTd) in patients with congestive heart failure (CHF).

STUDY DESIGN
The study included 20 patients (6 females, 14 males; mean age 57±11 years) who had symptomatic CHF with sinus rhythm, resting ejection fraction ≤%40, and no contraindications for beta-blockers. Coronary angiography showed coronary artery disease in nine patients, and dilated cardiomyopathy in 11 patients. Eight patients had myocardial infarction previously. All the patients had been receiving diuretics and angiotensin-converting enzyme inhibitors for one year. Carvedilol was initiated with a minimum dose of 3.125 mg twice daily, to be increased biweekly to reach the maximum tolerable dose (mean daily dose 42.5±13.6 mg). All the patients were assessed by electrocardiography and transthoracic echocardiography before and three months after treatment.

RESULTS
Significant decreases were observed in the following clinical and echocardiographic parameters: heart rate (p=0.001), systolic blood pressure (p=0.002), left atrial diameter (p<0.001), and left ventricular end-systolic (p<0.001) and end-diastolic (p=0.04) diameters. Left ventricular ejection fraction showed a significant increase (p<0.001). There was also a remarkable improvement in NYHA functional capacity in all the patients (p<0.05). Both corrected QTd (p=0.001) and QTd (p<0.001) significantly decreased. Maximum corrected QT and maximum QT did not change significantly (p>0.05), while minimum QT and minimum corrected QT significantly increased (p<0.001). No significant correlation was found between the carvedilol dose and the percent decrease in QTd (p>0.05).

CONCLUSION
Carvedilol is associated with significant decreases in corrected QTd in patients with CHF.

Keywords: Adrenergic beta-antagonists/therapeutic use, cardiomyopathies, electrocardiography; heart failure, congestive/ drug therapy

How to cite this article
Serdar Sevimli, Şakir Arslan, Fuat Gündoğdu, Enbiya Aksakal, Hakan Taş, Yekta Gürlertop, Hüseyin Şenocak, Sebahattin Ateşal, Necip Alp. Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. Turk Kardiyol Dern Ars. 2007; 35(5): 284-288

Corresponding Author: Serdar Sevimli, Türkiye
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