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Pharmaceuticals 2011, 4(5), 770-781; doi:10.3390/ph4050770

The Role of Carvedilol in the Treatment of Dilated and Anthracyclines-Induced Cardiomyopathy

1,* , 1,2, 1,3, 1, 1, 4 and 5
1 Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Niigata University of Pharmacy and Applied Life Sciences, Niigata City 956-8603, Japan 2 Department of Pharmacology, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia 3 Department of Pharmacology, Faculty of Medicine and Health Sciences, Syarif Hidayatullah Jakarta, State Islamic University, South Jakarta 15412, Indonesia 4 Department of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City 951-8510, Japan 5 First Department of Internal Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata City 951-8510, Japan
* Author to whom correspondence should be addressed.
Received: 4 March 2011 / Revised: 11 May 2011 / Accepted: 19 May 2011 / Published: 24 May 2011
(This article belongs to the Special Issue Betablockers)
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Although chronic sympathetic activation provides inotropic and chronotropic support to the failing heart, such activation may also have deleterious effects, including the direct cardiotoxic effects of catecholamines, activation of the renin-angiotensin-aldosterone system and an increase in myocardial oxygen demand. These observations indicate that β-blockade might be beneficial in the treatment of heart failure resulting from dilated cardiomyopathy or ischaemic heart disease. Carvedilol is a non-selective β-blocker acting on β1-, β2-, and α1-adrenoceptors. It possesses potent anti-oxidant and anti-apoptotic properties, along with neuroprotective, vasculoprotective, cardioprotective effects, and it has reduced overall mortality in patients with heart failure in controlled clinical trials. Its role in treating cardiomyopathy requires focus. The fact that anthracyclines are cardiotoxic seriously narrows their therapeutic index in cancer therapy. The cardiotoxic risk increases with the cumulative dose and may lead to congestive heart failure and dilated cardiomyopathy in adults and in children. This review focuses on recent research regarding the beneficial effects of carvedilol in the treatment of dilated cardiomyopathy and to revisit the available evidence on the cardioprotection of carvedilol when associated with anthracycline and to explain the mechanisms underlying the benefits of their co-administration.
Keywords: carvedilol; cardiomyopathy; cardioprotection carvedilol; cardiomyopathy; cardioprotection
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Watanabe, K.; Arozal, W.; Sari, F.R.; Arumugam, S.; Thandavarayan, R.A.; Suzuki, K.; Kodama, M. The Role of Carvedilol in the Treatment of Dilated and Anthracyclines-Induced Cardiomyopathy. Pharmaceuticals 2011, 4, 770-781.

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