The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
Differential Effects of β-Blockers in Patients With Heart Failure: A Prospective, Randomized, Double-Blind Comparison of the Long-Term Effects of Metoprolol Versus Carvedilol
Open accessAbstract
Background —Both metoprolol and carvedilol produce hemodynamic and clinical benefits in patients with chronic heart failure; carvedilol exerts greater antiadrenergic effects than metoprolol, but it is unknown whether this pharmacological difference results in hemodynamic and clinical differences between the 2 drugs. Methods and Results —We randomized 150 patients with heart failure (left ventricular ejection fraction ≤0.35) to double-blind treatment with either metoprolol or carvedilol. When compared with metoprolol (124±55 mg/d), patients treated with carvedilol (49±18 mg/d) showed larger increases in left ventricular ejection fraction at rest (+10.9±11.0 versus +7.2±7.7 U, P =0.038) and in left ventricular stroke volume and stroke work during exercise (both P <0.05) after 13 to 15 months of treatment. In addition, carvedilol produced greater decreases in mean pulmonary artery pressure and pulmonary wedge pressure, both at rest and during exercise, than metoprolol (all P <0.05). In contrast, the metoprolol group showed greater increases in maximal exercise capacity than the carvedilol group ( P =0.035), but the 2 drugs improved symptoms, submaximal exercise tolerance, and quality of life to a similar degree. After a mean of 23±11 months of follow-up, 21 patients in the metoprolol group and 17 patients in the carvedilol group died or underwent urgent transplantation. Conclusions —The present study demonstrates that during long-term therapy, carvedilol improves cardiac performance to a greater extent than metoprolol when administered to patients with heart failure in the doses shown to be effective in clinical trials. These differences were likely related to a greater antiadrenergic activity of carvedilol.
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Cites
The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial
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The Effect of Carvedilol on Morbidity and Mortality in Patients with Chronic Heart Failure
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The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure.
Guyatt, G. H., Sullivan, M. J., Thompson, P. J., Fallen, E. L., Pugsley, S. O., Taylor, D. W., & Berman, L. (1985) · Europe PMC (PubMed Central) · Cited by 2,069
Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy
Waagstein, F., Hjalmarson, A., Swedberg, K., Bristow, M. R., Gilbert, E. M., Camerini, F., Fowler, M. B., Silver, M. A., Johnson, M. R., & Goss, F. G. (1993) · The Lancet · doi:10.1016/0140-6736(93)92930-r · Cited by 1,234
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Cited by
Poole-Wilson, P. A., Swedberg, K., Cleland, J. G., Di Lenarda, A., Hanrath, P., Komajda, M., Lubsen, J., Lutiger, B., Metra, M., Remme, W. J., et al. (2003) · The Lancet · doi:10.1016/s0140-6736(03)13800-7 · Cited by 1,872
Self-citationFlynn, K. E., Piña, I. L., Whellan, D. J., Lin, L., Blumenthal, J. A., Ellis, S. J., Fine, L. J., Howlett, J. G., Keteyian, S. J., Kitzman, D. W., et al. (2009) · JAMA · doi:10.1001/jama.2009.457 · Cited by 737
(2004) · European Heart Journal · doi:10.1016/j.ehj.2004.06.002 · Cited by 557
Metra, M., Ponikowski, P., Dickstein, K., McMurray, J. J. V., Gavazzi, A., Bergh, C.-H., Fraser, A. G., Jaarsma, T., Pitsis, A., Mohacsi, P., et al. (2007) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2007.04.003 · Cited by 395
Self-citationThe influence of the human microbiome and probiotics on cardiovascular health
Ettinger, G., MacDonald, K., Reid, G., & Burton, J. P. (2014) · Gut Microbes · doi:10.4161/19490976.2014.983775 · Cited by 180
Metadata
- Authors
- Metra, M., Giubbini, R., Nodari, S., Boldi, E., Modena, M. G., & Cas, L. D.
- Venue
- Circulation
- Published
- 2000-08
- Volume
- 102
- Issue
- 5
- Pages
- 546-551
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2163130289
- Cited by
- 331
- References
- 26
- FWCI
- 26.56
- Type
- journal article
- Language
- en
- Open access
- bronze
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- CoChat. (2026). Citation check: Differential Effects of β-Blockers in Patients With Heart Failure: A Prospective, Randomized, Double-Blind Comparison of the Long-Term Effects of Metoprolol Versus Carvedilol. https://app.cochat.ai/papers/10.1161/01.cir.102.5.546
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- Metra, M., Giubbini, R., Nodari, S., Boldi, E., Modena, M. G., & Cas, L. D. (2000). Differential Effects of β-Blockers in Patients With Heart Failure: A Prospective, Randomized, Double-Blind Comparison of the Long-Term Effects of Metoprolol Versus Carvedilol. Circulation. https://doi.org/10.1161/01.cir.102.5.546
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