RESUMO
BACKGROUND: Beta-adrenoceptor antagonist (beta-blocker) therapy results in a significant improvement in left ventricular (LV) systolic function and prognosis in patients with chronic heart failure. Both carvedilol and nebivolol produce hemodynamic and clinical benefits in chronic heart failure, but it is unknown whether their peculiar pharmacologic properties produce different effects on LV function. OBJECTIVE: To assess the effects on LV function of nebivolol compared with carvedilol in patients with chronic heart failure and reduced LV systolic function. METHODS: Seventy patients with a LV ejection fraction Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico
, Benzopiranos/uso terapêutico
, Carbazóis/uso terapêutico
, Etanolaminas/uso terapêutico
, Insuficiência Cardíaca/tratamento farmacológico
, Propanolaminas/uso terapêutico
, Sístole/efeitos dos fármacos
, Função Ventricular Esquerda/efeitos dos fármacos
, Adulto
, Idoso
, Benzopiranos/farmacologia
, Carbazóis/farmacologia
, Carvedilol
, Eletrocardiografia/efeitos dos fármacos
, Etanolaminas/farmacologia
, Feminino
, Insuficiência Cardíaca/fisiopatologia
, Frequência Cardíaca/efeitos dos fármacos
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Nebivolol
, Propanolaminas/farmacologia
RESUMO
A 64-year-old man manifested a stroke two years after restoration of sinus rhythm through a radiofrequency catheter ablation. Transesophageal echocardiography demonstrated the presence of a thrombus in the left atrial appendage. Left atrial volumes and different parameters of atrial emptying showed that, despite the persistence of the sinus rhythm, atrial mechanical function was severely impaired. After atrial ablation procedures echocardiography can be useful to stratify patients according to their risk of developing embolic events and hence be of help in deciding whether or not discontinuation of anticoagulant therapy is the appropriate choice.