Sudden cardiac death risk factors in patients with heart failure treated with carvedilol
(2007) In Kardiologia Polska 65(12). p.1417-1424- Abstract
- Background: Chronic heart failure (CHF) is associated with a high risk of sudden cardiac death (SCID). Most frequently SCID occurs in patients with NYHA class II and III. Aim: To evaluate the influence of prolonged carvedilol therapy on SCID risk in CHF patients. Methods: The study included 86 patients (81 men and 5 women) aged 56.8 +/- 9.19 (35-70) years with CHF in NYHA class II and III receiving an ACE inhibitor and diuretics but not beta-blockers. At baseline and after 12 months of carvedilol therapy the following risk factors for SCID were analysed: in angiography - occluded infarct-related artery; in echocardiography - left ventricular ejection fraction (LVEF) < 30%, volume of the left ventricle (LVEDV) > 140 ml; in ECG at rest... (More)
- Background: Chronic heart failure (CHF) is associated with a high risk of sudden cardiac death (SCID). Most frequently SCID occurs in patients with NYHA class II and III. Aim: To evaluate the influence of prolonged carvedilol therapy on SCID risk in CHF patients. Methods: The study included 86 patients (81 men and 5 women) aged 56.8 +/- 9.19 (35-70) years with CHF in NYHA class II and III receiving an ACE inhibitor and diuretics but not beta-blockers. At baseline and after 12 months of carvedilol therapy the following risk factors for SCID were analysed: in angiography - occluded infarct-related artery; in echocardiography - left ventricular ejection fraction (LVEF) < 30%, volume of the left ventricle (LVEDV) > 140 ml; in ECG at rest - sinus heart rate (HRs) > 75/min, sustained atrial fibrillation, increased QTc; in 24-hour ECG recording - complex arrhythmia, blunted heart rate variability (SDNN < 100 ms) and abnormal turbulence parameters (TO and TS or one of them); in signal-averaged ECG - late ventricular potentials and prolonged QRS > 114 ms. The analysis of SCD risk factors in basic examination in patients who suddenly died was also performed. Results: During one-year carvedilol therapy heart transplantation was performed in 2 patients; 5 patients died. At 12 months the following risk factors for SCID were significantly changed: HRs > 75/min (50 vs. 16 patients, p=0.006), LVEF < 30% (37 vs. 14 patients, p=0.01), SDNN < 100 ms (19 vs. 9 patients, p=0.04). At 12 months the number of risk factors for SCD in each patient was significantly reduced (p=0.001). In patients who suddenly died we found a greater amount of SCID risk factors in basic examination (7 vs. 5) as compared to alive patients. Conclusions: Prolonged beta-adrenergic blockade reduces risk of sudden cardiac death through significant LVEF increase, reduction of HR at rest and improvement of HRV. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1407195
- author
- Nessler, Jadwiga ; Nessler, Bohdan ; Kitlinski, Mariusz LU ; Libionka, Anna ; Kubinyi, Ateksander ; Konduracka, Ewa and Piwowarska, Wieslawa
- organization
- publishing date
- 2007
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- heart rate turbulence, ejection fraction, late potentials, heart rate variability, rate, heart, risk factors, carvedilol, sudden cardiac death, heart failure
- in
- Kardiologia Polska
- volume
- 65
- issue
- 12
- pages
- 1417 - 1424
- publisher
- Polskie Towarzystwo Kardiologiczne
- external identifiers
-
- wos:000254491200002
- scopus:38049158368
- ISSN
- 1897-4279
- language
- English
- LU publication?
- yes
- id
- 600b9cce-66e9-49f7-809d-faccd4c27eb1 (old id 1407195)
- date added to LUP
- 2016-04-01 12:11:01
- date last changed
- 2022-01-26 23:58:40
@article{600b9cce-66e9-49f7-809d-faccd4c27eb1,
abstract = {{Background: Chronic heart failure (CHF) is associated with a high risk of sudden cardiac death (SCID). Most frequently SCID occurs in patients with NYHA class II and III. Aim: To evaluate the influence of prolonged carvedilol therapy on SCID risk in CHF patients. Methods: The study included 86 patients (81 men and 5 women) aged 56.8 +/- 9.19 (35-70) years with CHF in NYHA class II and III receiving an ACE inhibitor and diuretics but not beta-blockers. At baseline and after 12 months of carvedilol therapy the following risk factors for SCID were analysed: in angiography - occluded infarct-related artery; in echocardiography - left ventricular ejection fraction (LVEF) < 30%, volume of the left ventricle (LVEDV) > 140 ml; in ECG at rest - sinus heart rate (HRs) > 75/min, sustained atrial fibrillation, increased QTc; in 24-hour ECG recording - complex arrhythmia, blunted heart rate variability (SDNN < 100 ms) and abnormal turbulence parameters (TO and TS or one of them); in signal-averaged ECG - late ventricular potentials and prolonged QRS > 114 ms. The analysis of SCD risk factors in basic examination in patients who suddenly died was also performed. Results: During one-year carvedilol therapy heart transplantation was performed in 2 patients; 5 patients died. At 12 months the following risk factors for SCID were significantly changed: HRs > 75/min (50 vs. 16 patients, p=0.006), LVEF < 30% (37 vs. 14 patients, p=0.01), SDNN < 100 ms (19 vs. 9 patients, p=0.04). At 12 months the number of risk factors for SCD in each patient was significantly reduced (p=0.001). In patients who suddenly died we found a greater amount of SCID risk factors in basic examination (7 vs. 5) as compared to alive patients. Conclusions: Prolonged beta-adrenergic blockade reduces risk of sudden cardiac death through significant LVEF increase, reduction of HR at rest and improvement of HRV.}},
author = {{Nessler, Jadwiga and Nessler, Bohdan and Kitlinski, Mariusz and Libionka, Anna and Kubinyi, Ateksander and Konduracka, Ewa and Piwowarska, Wieslawa}},
issn = {{1897-4279}},
keywords = {{heart rate turbulence; ejection fraction; late potentials; heart rate variability; rate; heart; risk factors; carvedilol; sudden cardiac death; heart failure}},
language = {{eng}},
number = {{12}},
pages = {{1417--1424}},
publisher = {{Polskie Towarzystwo Kardiologiczne}},
series = {{Kardiologia Polska}},
title = {{Sudden cardiac death risk factors in patients with heart failure treated with carvedilol}},
volume = {{65}},
year = {{2007}},
}