CARVEDILOL IN HEART-FAILURE

Sustained oral treatment with beta blockers has been shown to improve symptoms in patients with chronic heart failure. In non-placebo-contro lled trials, the administration initially of a low dose, gradually inc reased over a period of weeks has been demonstrated to improve both sy mptoms, exercise capacity and left-ventricular ejection fraction. The rationale for this treatment is the enhanced adrenergic stimulation pr esent in heart failure which results in decreased sensitivity and dens ity of myocardial beta-receptors. Beta blockers may decrease this path ological adrenergic drive. Carvedilol, in addition to its beta-blockin g properties, is a vasodilator and is theoretically more suitable than earlier compounds of its potential to further decrease left-ventricul ar afterload. Recent studies have demonstrated symptomatic improvement with carvedilol in patients with heart failure, and a multicentre tri al has been designed to evaluate its efficacy and safety.