Comparison Of The Effect Of Carvedilol And Metoprolol On The Patients With Chronic Heart Failure

Objective To compare the effect of carvedilol and metoprolol on the patients with chronic heart failure(CHF), the difference between the two kinds of beta-blockers in therapy to CHF in two aspects was investigated1.To compare the changes of the parameters of heart function and ventricle dimension of the patients with heart failure who accepted the first therapy of metoprolol or carvedilol ,to examine the characteristic of acute reaction.2. To study the effect on the indexs of heart function by metoprolol and carvedilol in therapy to CHF and discuss the possible mechanism, to evaluate the long impact of the therapy on CHF by metoprolol and carvedilol through prognosis analysis between two groups.Method In the study ,patients object with mild or moderate cardiac dysfunction was grouped in two and put into clinic research, on the basis of standard medicine therapy of heart failure, added carvedilol or metoprolol in small dose respectively, increase dose by degrees to the mark dose gradually. After 18-20 months therapy, heart ECT were examined 3 times to evaluate the left ventricle function and volume. Result 1.Acute trial: ECT of two groups patients were examined before and after taking carvedilol(3.125mg) or metoprolol(6.25mg), EDV\ESV increased and LVEF decreased after taking medicine, but no statistic signifcance; Heart rate decreased obviously, there was no changes for heart function and other clinic symptom .2.Follow up: After 3 month therapy, LVEF increased in both groups obviously , but EDV|ESV reduced, and HR decreased(P<0.05) , SV reduced lightly (P>.05) . 3. After 18-20 months therapy, carvedilol(19case) or metoprolol(16case) , EDV|ESV decreased and LVEF increased obviously, HR reduced, heart function straighten , having furthermore statistic signifcance than 3 months'. Carvedilol was better than metoprolol in EDV and LVEF.Conclusion1. That Beta-blocker improved the heart function showed that there were nerve system over-activation ,which promot remodeling. 2. In the beginning of therapy, negative effects in force of contraction and frequency appeared, but it did not deteriorate heart failure. There was not a difference between groups .Choosing proper dose, negative effects in force of contraction and frequency can be decreased . 3. It restrained the damage of cardiac muscle induced by over activation of nerve and endorine system. heart failure with beta-blockers in long term therapy can improve and revers ventricular remodeling.4.Through a long period observation, a result was found that carvedilol had more predominance than metoprolol in reversing ventricular remodeling and improving heart function.