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The Role of Carvedilol in the Treatment of Dilated and Anthracyclines-Induced Cardiomyopathy
Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Niigata University of Pharmacy and Applied Life Sciences, Niigata City 956-8603, Japan
Department of Pharmacology, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia
Department of Pharmacology, Faculty of Medicine and Health Sciences, Syarif Hidayatullah Jakarta, State Islamic University, South Jakarta 15412, Indonesia
Department of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City 951-8510, Japan
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; in revised form: 11 May 2011 / Accepted: 19 May 2011 / Published: 24 May 2011
Abstract: 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
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MDPI and ACS Style
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.
Watanabe K, Arozal W, Sari FR, Arumugam S, Thandavarayan RA, Suzuki K, Kodama M. The Role of Carvedilol in the Treatment of Dilated and Anthracyclines-Induced Cardiomyopathy. Pharmaceuticals. 2011; 4(5):770-781.
Watanabe, Kenichi; Arozal, Wawaimuli; Sari, Flori R.; Arumugam, Somasundaram; Thandavarayan, Rajarajan A.; Suzuki, Kenji; Kodama, Makoto. 2011. "The Role of Carvedilol in the Treatment of Dilated and Anthracyclines-Induced Cardiomyopathy." Pharmaceuticals 4, no. 5: 770-781.