Key result
Verapamil significantly increased the mean ratio of early to late transmitral flow velocities compared to carvedilol (1.1 vs 0.7; 95% CI -0.6 to -0.1; P=0.015) in non-advanced dilated cardiomyopathy.
Why the study?
Does verapamil improve echocardiography parameters and functional status compared to carvedilol in patients with non-advanced dilated cardiomyopathy?
RCT (n=70)
Yes
Does verapamil improve echocardiography parameters and functional status compared to carvedilol in patients with non-advanced dilated cardiomyopathy?
Absolute Event Rate: 1.1% vs 0.7%
p-value: p=0.015
Verapamil may offer a safe and effective alternative to beta-blockers for improving functional status and diastolic echocardiographic parameters in patients with non-advanced dilated cardiomyopathy.
May support verapamil as alternative to carvedilol for diastolic parameters in non-advanced DCM; extends calcium-channel blocker options pending outcome trials.
OBJECTIVE: This study aimed to investigate the usefulness of the calcium-channel blocker verapamil in non-advanced dilated cardiomyopathy (DCM). METHODS: This was a randomised trial of 70 DCM patients treated with carvedilol (36 patients) and verapamil (instead of β-blocker; 34 patients) for 12 months. The remaining heart failure (HF) therapy was constant in both groups. The primary outcomes were to determine selected echocardiography parameters and functional status of patients. The secondary outcome included death, heart transplantation and re-hospitalisation due to HF progression. RESULTS: Of the primary outcomes, only the mean ratio of early to late transmitral flow velocities increased significantly in the verapamil-treated patients as compared with the carvedilol-based therapy (1.1 ± 0.3 vs. 0.7 ± 0.2; 95% CI -0.6 to -0.1; p = 0.015). Simultaneously, the Minnesota Quality of Life improved significantly in the verapamil group (95% CI 5.2-19.9; p = 0.002). It was accompanied by the favourable effect of verapamil therapy on exercise capacity in the 6-min walk test (95% CI 21.3-110.7; p = 0.005). CONCLUSION: The addition of verapamil to angiotensin-converting enzyme and aldosterone inhibitors in non-advanced DCM patients has been shown to have a neutral or even positive effect in a few patients.
No takes yet. Share an insight, caveat, or question.
Wojnicz et al. (2010) conducted an RCT in non-advanced dilated cardiomyopathy (DCM) (n=70). verapamil vs. carvedilol was evaluated on selected echocardiography parameters and functional status (mean ratio of early to late transmitral flow velocities) (95% CI -0.6 to -0.1, p=0.015). Verapamil significantly increased the mean ratio of early to late transmitral flow velocities compared to carvedilol (1.1 vs 0.7; 95% CI -0.6 to -0.1; P=0.015) in non-advanced dilated cardiomyopathy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: