Carvedilol improves renal hemodynamics in patients with chronic heart failure

Abstract

Compared to other ~-blockers, carvedilol may have a beneficial effect on renal hemodynamies via cq antagonism. To test this hypothesis, the renal hemodynamic effects of metoprolol and carvedilol were compared in a prospective, randomized, doubleblind, placebo-controlled investigation of 14 class III HF patients (age 58+3 yrs; LVEF 16+1%). Renal blood flow (RBF) and glomemlar filtration rate (GFR) were determined b y p aminohippuric acid and inulin clearances, respectively, at baseline and following 6 months of chronic therapy. Baseline patient characteristics including RBF and GFR were not different between the 3 groups. LVEF improved to a s imilar extent in both I~-blocker groups (metoprolol, 19% to 39%; carvedilol, 16% to 32%; both p=.02). Despite this, only carvedilol improved RBF (Figure; *p=.03 vs baseline; #t)=.02 carvedilol change vs metoprolol and placebo). Carvedilol also tended to increase GFR (63+7 to 90+_14, p=0.1). Conclusion: In contrast to the +~, ., m ~1 selective agent metoprolol, ,, carvedilol appears to improve ~~ (ml/mln)