Division of Cardiology, Department of Medicine, School of Medicine, University of Colorado, Aurora, Colorado, USA.
J Card Fail. 2011 Oct;17(10):875-7. doi: 10.1016/j.cardfail.2011.05.009. Epub 2011 Jun 23.
Heart failure (HF) and benign prostatic hypertrophy (BPH) are two conditions that commonly coexist in men 60 years and older. Carvedilol is the only β-adrenergic blocker approved for HF that also has additional α1-adrenergic blockade. As α1-adrenergic blockers are used in the treatment of BPH, it is intuitive that carvediolol could improve BPH symptoms. We present a case where carvedilol was replaced with bisoprolol resulting in acute urinary retention. When carvediolol was reinstituted, the patient's symptoms of BPH resolved. Benign prostatic hypertrophy was later diagnosed by digital rectal exam. Six month after reinstituting the carvediolol, the patient remains free of his BPH symptoms. This case suggests that carvedilol may be considered for the management of HF with systolic dysfunction in patients with concomitant BPH thus eliminating the need for an α1-adrenergic blockers.
心力衰竭（HF）和良性前列腺增生（BPH）是 60 岁及以上男性中常见的两种并存病症。卡维地洛是唯一一种被批准用于 HF 的β肾上腺素能阻滞剂，它还具有额外的α1肾上腺素能阻滞作用。由于α1肾上腺素能阻滞剂被用于治疗 BPH，因此直观地认为卡维地洛可以改善 BPH 症状。我们提出了一个病例，其中卡维地洛被换成比索洛尔导致急性尿潴留。当重新使用卡维地洛时，患者的 BPH 症状得到缓解。通过直肠指检诊断出良性前列腺增生。在重新使用卡维地洛 6 个月后，患者仍然没有 BPH 症状。这个病例表明，对于同时患有 BPH 的收缩功能障碍性 HF 患者，可考虑使用卡维地洛进行管理，从而无需使用α1肾上腺素能阻滞剂。
