Effect of Carvedilol on Heart Failure in Patients With a Functionally Univentricular Heart

Background: The effect of carvedilol on heart failure (HF) in patients with a functionally univentricular heart (UVH) remains unclear. Methods and Results: Carvedilol was used to treat HF in 51 patients with a UVH, classified into 3 groups: after the Fontan operation (F), after the bidirectional Glenn operation (G), and patients who had not undergone Fontan or Glenn operation (NF). Carvedilol therapy was started at a mean age of 10±12 years (range: 1 month to 34 years). The initial and maximum doses of carvedilol were 0.04±0.03 and 0.42±0.29mg·kg-1·day-1, respectively. After a mean follow-up of 11 months, the cardiothoracic ratio improved from 60±8 to 58±8% (P<0.01), and the dosage of furosemide was reduced from 1.4±0.9 to 0.7±0.7mg·kg-1·day-1 (P<0.01). The ejection fraction also improved from 35±12 to 40±11% (P<0.05), and this improvement was prominent in the F group (from 35±15 to 45±9%; P<0.05). Clinical signs, symptoms, and New York Heart Association functional class also improved. Conclusions: Carvedilol may play an important role in treating HF associated with a UVH. (Circ J 2011; 75: 1394-1399)