European journal of heart failure
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Eur. J. Heart Fail. · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialTolerability of carvedilol and ACE-Inhibition in mild heart failure. Results of CARMEN (Carvedilol ACE-Inhibitor Remodelling Mild CHF EvaluatioN).
Management guidelines for heart failure recommend ACE-I and beta-blockers. The perception of difficult up-titration might have added to the slow uptake of beta-blockers despite their mortality and morbidity benefits. ⋯ The safety profile was similar in all treatment arms. In contrast to common perception, there was no difference in tolerability between the ACE-I and carvedilol. This result is even more remarkable as the high prestudy use of ACE-I (65%) might have introduced a bias by selecting ACE-I tolerant patients, who were only switched from their former ACE-I to enalapril.
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Eur. J. Heart Fail. · Jun 2004
Case ReportsCardiogenic shock shortly after initial success of cardiac resynchronization therapy.
Cardiac resynchronisation therapy (CRT) has been shown to improve symptoms, exercise capacity and left ventricular function, as well as a reduction in morbidity/mortality in heart failure patients. Failures following initial success of this treatment are mostly related to lead dislodgement. Another entirely different reason is presented in this case study.