Pulmonary arterial hypertension treatment with carvedilol for heart failure: a randomized controlled trial

Abstract

ClinicalTrials.gov NCT01586156FUNDING. This project was supported by NIH R01HL115008 and R01HL60917 and in part by the National Center for Advancing Translational Sciences, UL1TR000439.

Assessment of Right Ventricular Function in the Research Setting: Knowledge Gaps and Pathways Forward. An Official American Thoracic Society Research Statement

“…Effects of neurohormonal modulators (e.g., inhibitors of the renin-angiotensin/aldosterone system) and b-adrenergic receptor antagonists on RV contractile function require further study. In particular, the effect of the latter is of great interest, because currently available studies yielded conflicting results of these drugs on clinical outcomes and RV function (259)(260)(261)(262)(263). RV inotropic agents may improve shortand/or long-term outcomes in acute and/or chronic PH, but their role (and potential for adverse events) is incompletely explored.…”

Basic Science and Clinical Trials: Accelerating the Future

“…11 Another trial of carvedilol in patients with PAH showed a decrease in heart rate and RV glycolysis, and proved to be safe in PAH patients, but did not show an increase in cardiac output or 6-minute walk distance (6MWD). 12 In light of the present data Dr Bogaard emphasized that he does not advocate use of beta-blockers in PAH patients, and that further clinical trials are needed with careful patient selection to identify patients who are most likely to respond to therapy. An alternative for targeting chronically activated sympathetic neurohormonal signaling in PAH may be to increase parasympathetic tone.…”

Clinical Trials Targeting Metabolism in Pulmonary Arterial Hypertension

“…The PAH Treatment with Carvedilol for Heart Failure (PAHTCH) trial was a double-blind, randomized, dose-ranging, 24-week trial of carvedilol in 30 patients with World Health Organization pulmonary hypertension (PH) Group 1, 3, or 4. 28 Carvedilol is a nonselective beta-blocker with vasodilator properties. Although carvedilol does not directly target a metabolic pathway, investigators assessed the effects of beta-blockade on RV glucose uptake as a maker of myocardial remodeling and hypoxia-inducible events.…”