Effects Of Carvedilol On Congestive Heart Failure And Its Effects On SFas

Objective: This study was to determine the clinical effects of carvedilol on congestive heart failmure(CHF) and its effects on serum solube Fas(sFas).Method: All 60 patients with CHF were treated with digitalis, diuretics, ACEI and nitroglycerin, and were divided randomly into two groups. The first group was carvedilol group, including 30 subjects, which were treated with carvedilol; The second group was conventional treatment group, including 30 subjects,which received placebo. In addition, 30 health subjects composed of normal control group.The fraction shortening (FS), left ejection fraction(EF), stroke volume (SV), left ventricular diastolic dimension (LVEDD), inter ventricular septum thick degree (IVSTd) and left ventricular posterior wall thick degree (LVPWTd) were measured with echocardio graphy, and the concentration of serum solube Fas was examined with the method of ELISA before treatment and 3 months after treatment.Result: 3 months after treatment, the cardiac function improved markedly in both group, but that of carvedilol group improved more significantly than that of conventional group, such as LVEDD (60.5 + 6.7 :in66.3?.3mm,P<0.05), FS(23.8?.4% : 17.8 + 6.1%, P<0.05), EF(49.4 ?.8% : 41.3 + 6.2%, P<0.05), D/T(3.08?.62 : 3.69 + 0.79, P<0.05). Before treatment, the level of serum sFas in all 60 patients with CHF increased significantly than that in normal subjects and it was correlated negatively with EF(r= -0.73, P < 0.001), and the level of sFas was decreased significantly in carvedilol group than that of conventional treatment group (0.94 + 0.26 : 1.18 + 0.32 u g/L, P<0.05) 3 months after treatment.Conclusion: (l)The combination of effects of the conventional treatment and caverdilol on CHF was better than effects of conventional treatment.(2)The effects of caverdilol on CHF patients might partly show the improvement of the myocardiac reconstruction.(3)The levels of serum sFas in patients with CHF perhaps indicated the status of myocyte apoptosis indirectly, and the effects of caverdilol on the improvement of the myocardiac reconstruction perhaps were related to the effects of caverdilol on myocyte apoptosis.