Objective：To investigate the changes of coronary flow reserve （CFR） of patients without heart failure of dilated cardiomyopathy （DCM） by non-invasive transthoracic stress echocardiography before and after the treatment of carvedilol.Method：Forty patients without heart failure of DCM were involved. 30 healthy subjects with normal angiography and negative ECG exercise test served as controls. Based on traditional treatments,all patients were given enough carvedilol in 6 months,and echocardiography was checked in the first and sixth month. Doppler measurements of distal left anterior descending were recorded at rest and hyperemia state by adenosine infusion,and CFR was calculated before and after the treatment. Result：①Compared with controls,no HF group had larger LAd and LVDd,lower LVEF and E/A before treatment （P〈0.05）. LAd,LVDd and LVEF of no HF group didn＇t change after 1 month,but improved after 6 months （P〈0.05）. ② Compared with controls,no HF group had lower hCFV and CFR before treatment （hCFV[63.72±5.81] vs [81.65±8.47] cm/s,P〈0.05; CFR 2.57±0.31 vs 3.20±0.29,P〈0.05）. After treatment of carvedilol,hCFV and CFR of these two groups rised after 1 and 6 months. Although hCFV and CFR of no HF groups were still lower than that in control group after 1 month （hCFV [70.75±6.08] vs [81.65±8.47]cm/s,P〈0.05;CFR 2.81±0.30 vs 3.20±0.29,P〈0.05）,there were no difference between no HF group after 6 months of DCM and controls （hCFV [78.93±6.88] vs [81.65±8.47] cm/s,P〉0.05;CFR 3.13±0.36 vs 3.20±0.29,P〉0.05）.Conclusion：Patients without heart failure had lower CFR. As the third generation -β locker,carvedilol could not only reverse ventricular remodelingof DCM,but also improve CFR of these patients after treatment of 1 and 6 months. CFR by stress echocardiography could early evaluate the effect of carvedilol prior to the index of traditional echocardiography.
Journal of Clinical Cardiology