Experiencia con el uso de carvedilol en el manejo ambulatorio de la insuficiencia cardiaca en un hospital del tercer nivel de la Seguridad Social en Costa Rica

experience in heart failure ambulatory therapy with carvedilol in a tertiary care hospital in costa rica. introduction. the prescription of carvedilol for the management of chronic heart failure has been shown to improve morbidity, mortality, ventricular function, cardiac remodeling and quality of life. the effect of carvedilol on various echocardiographic measures was studied retrospectively in a group of patients at an ambulatory clinic in a tertiary level hospital of the social security system in costa rica. methods. the study design was observational and retrospective with data obtained from patient medical records. the patients who were selected had a diagnosis of systolic heart failure with a left ventricle ejection fraction (lvef) of <40 % and were not receiving carvedilol at the time of their first echocardiogram. their demographic, clinical and therapeutic characteristics were recorded and the baseline values of ejection fraction, diastolic dimension and systolic dimension were compared with the values obtained after 6 to 24 months of carvedilol therapy. results. thirty-two patients were included in the study. the average initial lvef was 26,5 ± 7,6 %. after an average followup period of 16,4 months, the lvef was 31,8 ± 8,6 % (a change of +5,2 ± 8,2, p < 0,05). the initial left ventricle diastolic dimension was 63,8 ± 9,5 mm and the final diastolic dimension was 61,8 ± 9,4 mm (a change of -2,1 ± 5,7, p = 0,085. the initial left ventricle systolic dimension was 51,4 ± 11,8 mm and the final systolic dimension was 49, 4 ±11,1 mm (a change of 1,9 ± 8,1 mm, p = 0,271). conclusion. an improvement of the lvef and a stabilization of the systolic and diastolic dimensions was observed in this group of patients. this result appears to indicate a favorable reduction in cardiac remodeling.