Кардиоваскулярная терапия и профилактика (Jun 2008)
Carvedilol and bisoprolol effectiveness in patients with myocardial infarction and heart failure
Abstract
Aim. To assess carvedilol and bisoprolol effects on clinical symptoms, hemodynamics and morpho-functional heart characteristics in patients with myocardial infarction (MI) and chronic heart failure (CHF).Material and methods. The study included 40 patients with CHF and MI, randomized into two groups: Group I (n=20) received standard therapy and carvedilol, Group II (n=20) - standard therapy and bisoprolol.Results. In both groups, the therapy was associated with substantial clinical improvement and decrease in most parameters of circadian blood pressure (BP) profile. Carvedilol therapy was linked to greater reduction in daytime and nighttime systolic and diastolic BP variability. Significant reduction in left ventricular (LV) wall thickness and LV myocardial mass was observed in both groups.Conclusion. Additional therapy with carvedilol and bisoprolol improved clinical status of patients with MI and CHF. Carvedilol therapy had greater and more stable antihypertensive effect. After 12 weeks of carvedilol or bisoprolol treatment, similar LV hypertrophy (LVH) regression was observed. Carvedilol therapy was associated not only with LVH regression, but also with substantially increased LV contractility, improved LV diastolic function, and normalized diastole structure.