Objective: Administration of the beta-adrenergic receptor blocker carvedilol to patients with chronic heart failure leads to clinically significant benefits, including improvement in left ventricular systolic function in some, but not all, patients. We sought to determine the basis of the variable effect obtained with carvedilol in patients with heart failure. Carvedilol blocks both beta1-adrenergic and beta2-adrenergic receptors, and both receptors exist as polymorphisms. We aimed to determine whether these polymorphisms contribute to variability in response to carvedilol in patients with chronic heart failure.
Methods: We retrospectively and prospectively investigated 135 patients with nonischemic cardiomyopathy and chronic stable heart failure (New York Heart Association class II, III) treated with carvedilol. Baseline echocardiography was obtained before introduction of carvedilol and repeated after stabilization of a maximally tolerated dose of carvedilol (50-100 mg/day) for at least 1 year. Polymerase chain reaction and restriction fragment length polymorphism analysis were used to genotype beta1-adrenergic and beta2-adrenergic receptor polymorphisms.
Results: When grouped according to receptor polymorphisms patients were well matched for severity of heart failure, comorbidity and treatment. No significant difference was observed in baseline left ventricular ejection fraction (LVEF) between groups (P>0.05). After 1.5 years of treatment with carvedilol patients with Arg389Arg-beta1-adrenergic receptors had a significantly greater improvement in LVEF compared with Gly389 carriers (Arg389Arg 18.8%; Arg389Gly 9.4%; Gly389Gly 6.0%; P<0.001) whereas there were no differences attributable to other beta1-adrenergic and beta2-adrenergic receptor polymorphisms (P>0.05).
Conclusion: In patients with nonischemic dilated cardiomyopathy, carvedilol leads to a significantly greater improvement in LVEF in patients with the Arg389Arg-beta1 adrenergic receptor phenotype.
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Front Artif Intell
January 2025
Department of Computer Science and Artificial Intelligence, College of Computing and Information Technology, University of Bisha, Bisha, Saudi Arabia.
Cardiac disease refers to diseases that affect the heart such as coronary artery diseases, arrhythmia and heart defects and is amongst the most difficult health conditions known to humanity. According to the WHO, heart disease is the foremost cause of mortality worldwide, causing an estimated 17.8 million deaths every year it consumes a significant amount of time as well as effort to figure out what is causing this, especially for medical specialists and doctors.
View Article and Find Full Text PDFLancet Reg Health West Pac
January 2025
Division of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Background: Early diagnosis of chronic kidney disease (CKD) is crucial for timely intervention to delay disease progression and improve patient outcomes. However, data for clinical characteristics of Chinese patients with undiagnosed, early-stage CKD are lacking.
Methods: REVEAL-CKD is a multinational, observational study using real-world data in selected countries to describe factors associated with undiagnosed stage 3 CKD, time to diagnosis, and CKD management post diagnosis.
Health Sci Rep
January 2025
Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine Tsinghua University Beijing China.
Background And Aims: Pulse is an easily accessible life sign, while irregular pulse could be easily detected in daily life during blood pressure test. However, whether irregular pulse was associated with cardiovascular disease (CVD) or mortality has not been reported on a large population scale. Here, we investigated the association between irregular pulse, CVD, and CVD mortality, to explore the potential of irregular pulse as screening indicator for CVD and mortality, thus influencing health policy.
View Article and Find Full Text PDFJ Med Surg Public Health
December 2024
College of Nursing, Michigan State University, Michigan, Life Science, 1355 Bogue St Room A218, East Lansing, MI 48824, USA.
In-hospital cardiac arrest (IHCA) has been understudied relative to out-of-hospital cardiac arrest. Further, studies of IHCA have mainly focused on a limited number of pre-arrest patient characteristics (e.g.
View Article and Find Full Text PDFJACC Adv
February 2025
Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea.
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