βa Blockers have been shown to reverse left ventricular remodelling (LVR) and to reduce the severity of functional mitral regurgitation (FMR) in patients with chronic systolic heart failure.^1–,⁴ It is unclear, however, to what extent the beneficial effects of β blockers on LVR or FMR are influenced by the severity of left ventricular dilatation or FMR at the time of commencement of β blocker treatment. We retrospectively analysed serial echocardiograms taken at baseline and two years after commencement of carvedilol in 257 patients with chronic heart failure caused by left ventricular systolic dysfunction.

PATIENTS AND METHODS

The study population was drawn from a total population of 476 consecutive patients who were treated with carvedilol for this indication. Patients were excluded from the echocardiographic analysis for the following reasons: death within two years of commencing the medication (n  =  35); withdrawal from carvedilol because of non-fatal adverse events (n  =  63); cardiac surgery (before or after commencement of carvedilol) that may have influenced the left ventricular dimensions and the degree of FMR (n  =  80); technically unsatisfactory echocardiograms at baseline or follow up (n  =  41).

Echocardiographic assessment of left ventricular function and FMR was performed with a Hewlett Packard Sonos 5500 ultrasound system with 2.5 and 3.5 MHz transducers. Left …