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  • Title: Effects of short-term carvedilol on the cardiac sympathetic activity assessed by 123I-MIBG scintigraphy.
    Author: Miranda SM, Mesquita ET, Dohmann HF, Azevedo JC, Barbirato GB, Freire Fde L, Ribeiro ML, Nóbrega AC, Coimbra A, Mesquita CT.
    Journal: Arq Bras Cardiol; 2010 Mar; 94(3):308-12, 328-32. PubMed ID: 20730258.
    Abstract:
    BACKGROUND: Autonomic alterations in heart failure are associated with an increase in morbimortality. Several noninvasive methods have been employed to evaluate the sympathetic function, including the Meta-Iodobenzylguanidine (123I-MIBG) scintigraphy imaging of the heart. OBJECTIVE: to evaluate the cardiac sympathetic activity through 123I-MIBG scintigraphy, before and after three months of carvedilol therapy in patients with heart failure and left ventricular ejection fraction (LVEF) < 45%. PATIENTS AND METHODS: Sixteen patients, aged 56.3 +/- 12.6 years (11 males), with a mean LVEF of 28% +/- 8% and no previous use of beta-blockers were recruited for the study. Images of the heart innervation were acquired with 123I-MIBG, and the serum levels of catecholamines (epinephrine, dopamine and norepinephrine) were measured; the radioisotope ventriculography (RIV) was performed before and after a three-month therapy with carvedilol. RESULTS: Patients' functional class showed improvement: before the treatment, 50% of the patients were FC II and 50% were FC III. After 3 months, 7 patients were FC I (43.8%) and 9 were FC II (56.2%), (p = 0.0001). The mean LVEF assessed by RIV increased from 29% to 33% (p = 0.017). There was no significant variation in cardiac adrenergic activity assessed by 123I-MIBG (early and late resting images and washout rate). No significant variation was observed regarding the measurement of catecholamines. CONCLUSION: The short-term treatment with carvedilol promoted the clinical and LVEF improvement. However, this was not associated to an improvement in the cardiac adrenergic activity, assessed by 123I-MIBG scintigraphy, as well as the measurement of circulating catecholamines.
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