Carvedilol therapy is associated with a sustained decline in brain natriuretic peptide levels in patients with congestive heart failure.

Background: Beta-blocker therapy improves symptoms, left ventricular ejection fraction (LVEF), and survival in patients with congestive heart failure, but chronic effects on neurohormones have not been extensively investigated. Therefore, we examined the neurohumoral effects of carvedilol.

Methods: Fifty-five patients with New York Heart Association (NYHA) classes II-III congestive heart failure and LVEF < or =35% entered the study with intention to assess LVEF, NYHA class, plasma brain natriuretic peptide (BNP), N-terminal atrial natriuretic peptide (NANP), big-endothelin, endothelin-1, norepinephrine, and angiotensin II at baseline and at 6 and 12 months after initiation of carvedilol.