OBJECTIVETo investigate the effects of carvedilol and metoprolol on the expression of autoantibodies against cardiac β(1), β(2) and α(1) adrenergic receptors in aged patients with chronic heart failure (CHF) and ventricular arrhythmia (VA).

METHODSSixty-eight patients with CHF and VA were randomly divided metoprolol treatment group or carvedilol treatment group on the basis of digoxin and diuretic treatment. All patients were followed up for six months cardiac function was monitored by echocardiography, VA by Holter and the three autoantibodies by enzyme-linked immunosorbent assay (ELISA).

RESULTS(1) Systolic blood pressure and brain natriuretic peptide (BNP) were significantly lower in carvedilol group than that in metoprolol group (P < 0.05). (2) The positive ratio of autoantibodies against the cardiac β(1) adrenergic receptor was significantly decreased compared with that of pre-treatment (P < 0.05) in metoprolol group. The positive ratios of autoantibodies against cardiac β(1), β(2) and α(1)-adrenergic receptors were all significantly decreased compared with that of pre-treatment (P < 0.01) in carvedilol group. Moreover, the incidence of VA was significantly decreased in carvedilol group (P < 0.05) but not in metoprolol group.

CONCLUSIONCarvedilol is superior to metoprolol on decreasing the incidence of VA in aged patients with chronic heart failure and ventricular arrhythmia.