Novel mechanisms in the treatment of heart failure: Inhibition of oxygen radicals and apoptosis by carvedilol

Carvedilol is a novel cardiovascular drug of proven efficacy in the treatment of hypertension, angina, and heart failure. Several mechanisms may account for the beneficial effects of carvedilol in patients with heart failure. As with other β-blockers, blockade of cardiac β-adrenergic receptors (both...

Full description

Saved in:
Bibliographic Details
Published in:Progress in cardiovascular diseases 1998-07, Vol.41 (1), p.17-24
Main Authors: Feuerstein, Giora, Yue, Tian-Li, Ma, Xinliang, Ruffolo, Robert R.
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Animals
Antioxidants - therapeutic use
Apoptosis - drug effects
Carbazoles - therapeutic use
Free Radical Scavengers - therapeutic use
Free Radicals
Heart Failure - drug therapy
Heart Failure - metabolism
Heart Failure - pathology
Humans
Myocardium - metabolism
Oxidative Stress
Propanolamines - therapeutic use
Reactive Oxygen Species
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Carvedilol is a novel cardiovascular drug of proven efficacy in the treatment of hypertension, angina, and heart failure. Several mechanisms may account for the beneficial effects of carvedilol in patients with heart failure. As with other β-blockers, blockade of cardiac β-adrenergic receptors (both β 1 and β 2), and hence reduction of cardiac work load and oxygen consumption, plays an important role in the actions of this agent. Additional benefit is provided by vasodilation (α 1-adrenergic blockage) at peripheral resistance vessels, which decreases preload and after-load, thereby further reducing cardiac work and wall tensions. In addition, potential advantages of carvedilol resulting from α 1-adrenergic blockade are likely because α 1-adrenergic receptors mediate cardiac remodeling by inducing hypertrophy. Finally, carvedilol is a potent antioxidant and is unique among β-blockers in this respect. In recent years, evidence has accumulated in support of the role played by reactive oxygen radicals in chronic pathological states of the myocardium. In this article, the role of oxygen radicals in heart failure is discussed with special reference to apoptosis, a phenomenon believed to be involved in progressive cardiac myocyte loss in ischemic or myopathic heart diseases. The potential role of the antioxidant actions of carvedilol, especially in prevention of apoptotic cell death, is highlighted as a novel mechanism of action in heart failure.
ISSN:0033-0620
1532-8643
DOI:10.1016/S0033-0620(98)80027-3