Original Contribution
difference is not statistically significant owing to the low-density sample, it is considerable.17
In 2004, Mukai et al. verified the effects of carvedilol at an initial dose of 2 mg per day increasing to 10–20 mg per day in five patients suffering from cardiomyopathy caused by anthracyclines. The study showed that carvedilol was successful in improving patients’ symptoms and maintaining ventricular function and diastolic and systolic diameters.12
Therefore, it is necessary to study the role of carvedilol in treating clinical cases, considering its possible effect in treating and preventing cardiomyopathy resulting from chemotherapy.
This finding contradicts the results of studies showing that cardiomyopathy caused by anthracyclines is irreversible.18
1. Kurihara C, Nishimura T, Nawata K, et al., Successful bridge to recovery with VAD implantation for anthracycline-induced cardiomyopathy, J Artif Organs, 2011;14:249–52.
2. Christiansen S, Recovery from anthracycline cardiomyopathy – how can it be explained?, J Heart Lung Transplant, 2009;28:751.
3. Cardinale D, Colombo A, Lamantia G, et al., Anthracycline- induced cardiomyopathy: clinical relevance and response to pharmacologic therapy, J Am Coll Cardiol, 2010;55:213–20.
4. Richter R, Grumpelt U, Mittler U, et al., [Echocardiography studies for detection of cardiotoxic side effects of anthracycline therapy in childhood], Monatsschr Kinderheilkd, 1990;138:823–7. Article in German.
5. Simmons A, Vacek JL, Meyers D, Anthracycline-induced cardiomyopathy, Postgrad Med, 2008;120:67–72.
6. Pihkala J, Sariola H, Saarinen UM, Myocardial function and postmortem myocardial histology in children given anthracycline therapy for cancer, Pediatr Hematol Oncol, 1994;11:259–69.
7. Keefe DL, Anthracycline-induced cardiomyopathy, Semin Oncol, 2001;28:2–7.
8. Godoy LY, Fukushige J, Igarashi H, et al., Anthracycline-induced cardiotoxicity in children with malignancies, Acta Paediatr Jpn, 1997;39:188–93.
9. Amigoni M, Giannattasio C, Fraschini D, et al., Low anthracyclines doses-induced cardiotoxicity in acute lymphoblastic leukemia long- term female survivors, Pediatr Blood Cancer, 2010;55:1343–7.
10. Hauser M, Gibson BS, Wilson N, Diagnosis of anthracycline- induced late cardiomyopathy by exercise-spiroergometry and stress-echocardiography, Eur J Pediatr, 2001;160:607–10.
11. Florenzano F, Salman P, Carvedilol for anthracycline
The American Heart Hospital Journal
It should be noted that the suggested dose of carvedilol in patients with heart failure is 12.5–50 mg, according to the MOCHA study.19
There is no general agreement
on the appropriate dose of carvedilol in cardiovascular patients because the protective effect of the drug on cardiomyopathy caused by chemotherapy has not yet been comprehensively studied and further studies are required.20
It should also be noted that a daily dose of 12.5 mg carvedilol may lead to decrease of echocardiography and tissue Doppler in favor of diastolic disorders, and a daily dose of 25 mg carvedilol may lead to decrease of echocardiography and tissue Doppler in favor of diastolic and diastolic disorders. n
cardiomyopathy prevention, J Am Coll Cardiol, 2007;49:2142–3.
12. Mukai Y, Yoshida T, Nakaike R, et al., Five cases of anthracycline- induced cardiomyopathy effectively treated with carvedilol, Intern Med, 2004;43:1087–8.
13. Yeoh T, Hayward C, Benson V, et al., A randomised, placebo- controlled trial of carvedilol in early familial dilated cardiomyopathy, Heart Lung Circ, 2011;20:566–73.
14. Pereira GG, Silva AM, Diogo CV, et al., Drug-induced cardiac mitochondrial toxicity and protection: from doxorubicin to carvedilol, Curr Pharm Des, 2011;17:2113–29.
15. Santos DL, Moreno AJ, Leino RL, et al., Carvedilol protects against doxorubicin-induced mitochondrial cardiomyopathy, Toxicol Appl Pharmacol, 2002;185:218–27.
16. Cruz N, Arocho L, Rosario L, et al., Chronic administration of carvedilol improves cardiac function in 6-month-old Syrian cardiomyopathic hamsters, Pharmacology, 2007;80:144–50.
17. Kalay N, Basar E, Ozdogru I, et al., Protective effects of carvedilol against anthracycline-induced cardiomyopathy, J Am Coll Cardiol, 2006;48:2258–62.
18. Yoshikawa E, Marui A, Tsukashita M, et al., Carvedilol may alleviate late cardiac remodelling following surgical ventricular restoration, Eur J Cardiothorac Surg, 2010;37:362–7
19. Fan Y, Lin JH, Dong G, et al., [The effect of carvedilol on coronary flow reserve in patients with dilated cardiomyopathy], Zhonghua Nei Ke Za Zhi, 2010;49:217–9. Article in Chinese.
20. Erdogan I, Ozer S, Karagoz T, et al., Treatment of dilated cardiomyopathy with carvedilol in children, Turk J Pediatr. 2009;51:354–60.
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Protective Effect of Carvedilol in Cardiomyopathy Caused by Anthracyclines
Winter 2011
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