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

ALP, Necip; ŞENOCAK, Hüseyin; ATEŞAL, Sebahattin; SEVİMLİ, Serdar; Aksakal, Enbiya; TAŞ, Hakan; GÜRLERTOP, Hanefi Yekta; GÜNDOĞDU, FUAT; ARSLAN, SAKIR

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

Serdar SEVİMLİ, (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Şakir ARSLAN, (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Fuat GÜNDOĞDU, (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Enbiya AKSAKAL, (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Hakan TAŞ, (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Hanefi Yekta GÜRLERTOP, (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Hüseyin ŞENOCAK, (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Sebahattin ATEŞAL, (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Necip ALP (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Türk Kardiyoloji Derneği Arşivi

0 1

Yıl: 2007 Cilt: 35 Sayı: 5 Sayfa Aralığı: 284 - 288 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

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

Öz:

Amaç: Bu çalışmada, konjestif kalp yetersizliği (KHY) olan hastalarda karvedilol tedavisinin düzeltilmiş QT dispersiyonu (QTd) üzerine etkisi araştırıldı. Çalışma planı: Çalışmaya semptomatik (KHY) olan 20 hasta alındı (6 kadın, 14 erkek; ort. yaş 57±11). Tüm hastalar sinus ritminde idi, dinlenme ejeksiyon fraksiyonu ≤%40 idi ve beta-bloker için herhangi bir kontrendikasyon yoktu. Koroner anjiyografide dokuz olguda koroner arter hastalığı, 11 olguda dilate kardiyomiyopati saptandı. Sekiz hasta daha önce miyokard infarktüsü geçirmişti. Tüm hastalar en az bir yıl süreyle diüretik ve anjiyotensin dönüştürücü enzim inhibitörü kullanmaktaydı. Karvedilol tedavisine minimum dozda (3.125 mg x 2) başlandı; doz 15 günde bir artırılarak, hastanın tolere edeceği maksimum doza çıkıldı (günlük ort. 42.5±13.6 mg). Tüm hastalar tedaviden önce ve üç ay sonra elektrokardiyografi ve transtorasik ekokardiyografi ile değerlendirildi. Bulgular: Klinik ve ekokardiyografik parametrelerden anlamlı düşüş gözlenenler şunlardı: kalp hızı (p=0.001), sistolik kan basıncı (p=0.002), sol atriyum çapı (p<0.001), sol ventrikül sistol sonu (p<0.001) ve diyastol sonu (p=0.04) çapları. Sol ventrikül ejeksiyon fraksiyonu anlamlı artış gösterdi (p<0.001). Tüm hastaların NYHA fonksiyonel kapasitesinde anlamlı iyileşme görüldü (p<0.05). Hem düzeltilmiş QTd (p=0.001), hem de QTd’deki (p<0.001) düşme anlamlı idi. Maksimum düzeltilmiş QT ve maksimum QT’de anlamlı değişiklik olmadı (p>0.05); minimum QT ve minimum düzeltilmiş QT ise anlamlı artış gösterdi (p<0.001). Karvedilol dozu ile QTd’deki yüzdelik düşüş arasında anlamlı ilişki görülmedi (p>0.05). Sonuç: Karvedilol, KHY’li hastalarda düzeltilmiş QTd'yi anlamlı derecede düşürmektedir.

Anahtar Kelime: İlaç tedavisi Kalp yetmezliği carvedilol QT dispersiyonu

Konular: Kalp ve Kalp Damar Sistemi

Konjestif kalp yetersizliği olan hastalarda karvedilol tedavisi QT dispersiyonunda düzelme sağlamaktadır

Öz:

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.

Anahtar Kelime: QT dispersion Drug Therapy Heart Failure carvedilol

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	SEVİMLİ S, ARSLAN S, GÜNDOĞDU F, Aksakal E, TAŞ H, GÜRLERTOP H, ŞENOCAK H, ATEŞAL S, ALP N (2007). Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. , 284 - 288.
Chicago	SEVİMLİ Serdar,ARSLAN SAKIR,GÜNDOĞDU FUAT,Aksakal Enbiya,TAŞ Hakan,GÜRLERTOP Hanefi Yekta,ŞENOCAK Hüseyin,ATEŞAL Sebahattin,ALP Necip Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. (2007): 284 - 288.
MLA	SEVİMLİ Serdar,ARSLAN SAKIR,GÜNDOĞDU FUAT,Aksakal Enbiya,TAŞ Hakan,GÜRLERTOP Hanefi Yekta,ŞENOCAK Hüseyin,ATEŞAL Sebahattin,ALP Necip Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. , 2007, ss.284 - 288.
AMA	SEVİMLİ S,ARSLAN S,GÜNDOĞDU F,Aksakal E,TAŞ H,GÜRLERTOP H,ŞENOCAK H,ATEŞAL S,ALP N Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. . 2007; 284 - 288.
Vancouver	SEVİMLİ S,ARSLAN S,GÜNDOĞDU F,Aksakal E,TAŞ H,GÜRLERTOP H,ŞENOCAK H,ATEŞAL S,ALP N Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. . 2007; 284 - 288.
IEEE	SEVİMLİ S,ARSLAN S,GÜNDOĞDU F,Aksakal E,TAŞ H,GÜRLERTOP H,ŞENOCAK H,ATEŞAL S,ALP N "Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure." , ss.284 - 288, 2007.
ISNAD	SEVİMLİ, Serdar vd. "Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure". (2007), 284-288.

APA	SEVİMLİ S, ARSLAN S, GÜNDOĞDU F, Aksakal E, TAŞ H, GÜRLERTOP H, ŞENOCAK H, ATEŞAL S, ALP N (2007). Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. Türk Kardiyoloji Derneği Arşivi, 35(5), 284 - 288.
Chicago	SEVİMLİ Serdar,ARSLAN SAKIR,GÜNDOĞDU FUAT,Aksakal Enbiya,TAŞ Hakan,GÜRLERTOP Hanefi Yekta,ŞENOCAK Hüseyin,ATEŞAL Sebahattin,ALP Necip Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. Türk Kardiyoloji Derneği Arşivi 35, no.5 (2007): 284 - 288.
MLA	SEVİMLİ Serdar,ARSLAN SAKIR,GÜNDOĞDU FUAT,Aksakal Enbiya,TAŞ Hakan,GÜRLERTOP Hanefi Yekta,ŞENOCAK Hüseyin,ATEŞAL Sebahattin,ALP Necip Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. Türk Kardiyoloji Derneği Arşivi, vol.35, no.5, 2007, ss.284 - 288.
AMA	SEVİMLİ S,ARSLAN S,GÜNDOĞDU F,Aksakal E,TAŞ H,GÜRLERTOP H,ŞENOCAK H,ATEŞAL S,ALP N Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. Türk Kardiyoloji Derneği Arşivi. 2007; 35(5): 284 - 288.
Vancouver	SEVİMLİ S,ARSLAN S,GÜNDOĞDU F,Aksakal E,TAŞ H,GÜRLERTOP H,ŞENOCAK H,ATEŞAL S,ALP N Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure. Türk Kardiyoloji Derneği Arşivi. 2007; 35(5): 284 - 288.
IEEE	SEVİMLİ S,ARSLAN S,GÜNDOĞDU F,Aksakal E,TAŞ H,GÜRLERTOP H,ŞENOCAK H,ATEŞAL S,ALP N "Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure." Türk Kardiyoloji Derneği Arşivi, 35, ss.284 - 288, 2007.
ISNAD	SEVİMLİ, Serdar vd. "Carvedilol therapy is associated with improvement in QT dispersion in patients with congestive heart failure". Türk Kardiyoloji Derneği Arşivi 35/5 (2007), 284-288.