Author + information
- Dai-Trang Elizabeth Le,
- Marco Pascotto,
- Howard Leong-Poi,
- Ibrahim Sari,
- Antonio Micari and
- Sanjiv Kaul
The superiority of carvedilol (C) over metoprolol (M) in congestive heart failure is controversial. We hypothesized that C is superior to M in chronic ischemic cardiomyopathy (CIC) because of its better anti-inflammatory and pro-angiogenic effects.
In a canine model of multivessel CIC, we randomized animals into sham, placebo, M and C groups after development of left ventricular (LV) dysfunction and followed them for 3 months after treatment. We measured LV function and myocardial blood flow (MBF) at rest and during dobutamine stress and leukocyte count and cytokine levels from interstitial fluid collected from intramyocardial microcatheters.
Hemodynamic effects of C and M were similar at rest and stress, but at 3 months both rest and stress wall thickening were better in C compared to M. Resting MBF improved the most in C as did the stress endocardial/epicardial MBF ratio. Myocardial fluid showed greater attenuation of leukocytosis with C compared to M, which was associated with higher IL-10 and angiopoietin-2 levels.
In a model of multivessel CIC, 3 months of C treatment resulted in better rest and stress regional function compared to M, which was associated with better improvement in rest endocardial MBF and a higher endocardial/epicardial MBF ratio during stress. These changes were related to higher myocardial levels of the anti-inflammatory cytokine IL-10 and angiogenesis-promoting cytokine angiopoietin-2. Thus in the doses used, C is superior to M in CIC.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Anti-Ischemic Therapies
Abstract Category: 9. Chronic CAD/Stable Ischemic Heart Disease: Basic
Presentation Number: 1194-64
- 2013 American College of Cardiology Foundation