The Development of Tolerance to α1-Adrenoceptor Blockade With Chronic Carvedilol Treatment

Exclusion Criteria

• •1. active myocarditis
• •2. congenital heart disease
• •3. uncorrected, hemodynamically significant stenotic valvular disease
• •4. hypertrophic cardiomyopathy
• •5. Asthma or other obstructive airway diseases requiring bronchodilators
• •6. Heart rate \< 60 beats/min, supine systolic blood pressure \< 85 mm Hg, supine diastolic blood pressure \> 90 mm Hg
• •7. Uncontrolled Hypertension (Systolic BP \>140 mmHg, Diastolic BP \> 90 mmHg).
• •8. Sick sinus syndrome, Mobitz type 2 second degree AV block or third degree AV block unless controlled with an artificial implantable pacemaker
• •9. NYHA functional class IV symptoms
• •10. Treatment with an excluded medication (see Excluded Medications below)
• •11. Myocardial infarction or coronary artery intervention (CABG or angioplasty) within three months
• •12. Unstable angina pectoris
• •13. Presence of any progressive systemic disease that would be expected to impact the patient's outcome over the time course of the study
• •14. Uncorrected endocrine disorders including primary aldosteronism, pheochromocytoma, hyperthyroidism, hypothyroidism, brittle type 1 diabetes mellitus
• •15. Evidence of significant renal disease (serum creatinine \> 2.5 mg/dl), or hepatic disease (transaminase level \> three fold higher than laboratory normal)
• •16. Symptomatic peripheral vascular disease
• •17. Inability or unwillingness to cooperate with study or give written informed consent