Effect of carvedilol on survival in severe chronic heart failure

Packer, Milton; Coats, A.J.S.; Fowler, Michael B.

doi:10.1016/s1062-1458(01)00477-9

Cited by 683 publications

(591 citation statements)

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“…Patients with a peak VO 2 b 14 ml/kg/min [8,10], and/or in NYHA class III to IV, with a LVEFb 25% may have an annual mortality rate of only 11-12% if euvolaemic and treated with beta-blockers and ACE inhibitors [12,13]. Indeed, patients with a normal LVEF and a recent HF hospitalisation may have a poorer prognosis [14,15].…”

Section: Comparison With Previous Definitionsmentioning

confidence: 99%

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Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

Metra

Ponikowski²,

Dickstein

et al. 2007

European J of Heart Fail

353

242

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Therapy has improved the survival of heart failure (HF) patients. However, many patients progress to advanced chronic HF (ACHF). We propose a practical clinical definition and describe the characteristics of this condition.Patients that are generally recognised as ACHF often exhibit the following characteristics: 1) severe symptoms (NYHA class III to IV); 2) episodes with clinical signs of fluid retention and/or peripheral hypoperfusion; 3) objective evidence of severe cardiac dysfunction, shown by at least one of the following: left ventricular ejection fraction b 30%, pseudonormal or restrictive mitral inflow pattern at Dopplerechocardiography; high left and/or right ventricular filling pressures; elevated B-type natriuretic peptides; 4) severe impairment of functional capacity demonstrated by either inability to exercise, a 6-minute walk test distance b 300 m or a peak oxygen uptake b 12-14 ml/kg/min; 5) history of N1 HF hospitalisation in the past 6 months; 6) presence of all the previous features despite optimal therapy. This definition identifies a group of patients with compromised quality of life, poor prognosis, and a high risk of clinical events. These patients deserve effective therapeutic options and should be potential targets for future clinical research initiatives.

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Section: Comparison With Previous Definitionsmentioning

confidence: 99%

“…The benefits of beta-blockers are at least as great in patients with severe HF as in those with less advanced disease [12,13].…”

Section: Beta-blockersmentioning

confidence: 99%

Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

Metra

Ponikowski²,

Dickstein

et al. 2007

European J of Heart Fail

353

242

View full text Add to dashboard Cite

show abstract

“…NYHA class II patients have a better prognosis; however, they are at a proportionally higher risk of sudden cardiac death ('drop'). Patients with class IV symptoms have a oneyear mortality as high as 75% and a significantly higher risk of dying of progressive heart failure characterized by increasing shortness of breath, orthopnea, and decreasing blood pressure and level of consciousness ('drown') (153)(154)(155). Patients in NYHA class II to III who receive an ICD may progress to class IV symptoms, with the likely mode of death changing from drop to drown.…”

Section: Practical Tipsmentioning

confidence: 99%

Canadian Cardiovascular Society consensus conference recommendations on heart failure 2006: Diagnosis and management

Arnold¹,

Liu²,

Demers³

et al. 2006

Canadian Journal of Cardiology

363

256

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“…The yearly mortality in patients with severe heart failure in the COPERNICUS trial was 11%, despite the use of ACE inhibitors as well as β-blockers. 1 In patients with end-stage heart failure, heart transplantation (HTx) is the only therapy which improves functional capacity, quality of life and provides a better life expectancy. 2,3 However, because of the limited numbers of donor organs available, resulting in a very long waiting time with potential haemodynamic deterioration, a growing number of patients are undergoing implantation of mechanical assist devices to bridge this period to transplantation.…”

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confidence: 99%

Left ventricular assist device: a functional comparison with heart transplantation

Pruijsten

Jonge²,

Kirkels³

et al. 2008

NHJL

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Background. A growing number of patients with end-stage heart failure undergo implantation of ventricular assist devices as a bridge to heart transplantation. Objectives. In this study we investigated whether functional and haemodynamic recovery after implantation is sufficient to warrant the use of them as long-term alternative to heart transplantation. Methods. We compared peak VO 2 of a group of patients three months after implantation of a ventricular assist device and three months after heart transplantation. Furthermore, we analysed the degree of haemodynamic recovery, by comparing plasma levels of BNP and creatinine before and after implantation of the device. Results. After implantation of a ventricular assist device, exercise capacity improved considerably; three months after implantation peak VO 2 was 20.0±4.9 ml/kg/min (52% of predicted for age and gender). After heart transplantation exercise capacity improved even further; 24.0±3.9 ml/ kg/min (62% of predicted for age and gender) (p<0.001). In the three months after implantation, BNP plasma levels decreased from 570±307 pmol/l to 31±25 pmol/l and creatinine levels decreased from 191±82 µmol/l to 82±25 µmol/l, indicating significant unloading of the ventricles and haemodynamic recovery. Conclusion. With regard to functional and haemodynamic recovery, the effect of implantation of a ventricular assist device is sufficient to justify its use as an alternative to heart transplantation. (Neth Heart J 2008;16:41-6.)

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Effect of carvedilol on survival in severe chronic heart failure

Cited by 683 publications

References 0 publications

Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

Canadian Cardiovascular Society consensus conference recommendations on heart failure 2006: Diagnosis and management

Left ventricular assist device: a functional comparison with heart transplantation

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