Effect of Beta-blockade and ACE Inhibition on B-type Natriuretic Peptides in Stable Patients with Systolic Heart Failure

Rosenberg, Jens; Gustafsson, Finn; Remme, Willem J.; Riegger, G. A. J.; Hildebrandt, Per

doi:10.1007/s10557-008-6099-6

Cited by 34 publications

(27 citation statements)

References 38 publications

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“…So, although the total cardiac function and exercise tolerance improved and serum concentrations of the assessed plasma biomarkers signifi cantly decreased there was a distinct diversity in biomarkers' predictive properties. In concordance with previous reports [16][17][18], baseline BNP level was a strong predictor of all-cause mortality but in contrast to them it was not prognostic of subsequent cardiovascular hospitalizations. Further, on-treatment changes in BNP had no role in prediction of mortality, hospitalizations, or therapeutic response to carvedilol.…”

Section: Discussionsupporting

confidence: 90%

Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol

Nessler¹,

Nessler²,

Gołębiowska-Wiatrak³

et al. 2013

Cardiol J.

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Background:The role of infl ammatory and hemodynamic stress biomarkers in heart failure (HF) patients treated de novo with beta-blockers has been poorly studied. Methods: A total of 86 patients (age 56 ± 9 years, 81 men) with left ventricular ejection fraction (LVEF) < 40% and previously not treated with beta-blockers were initiated on carvedilol. At baseline and 12 months later we performed echocardiography, cardiopulmonary exercise testing, and determined serum levels of B-type natriuretic peptide (BNP), endothelin-1 (ET-1), C-reactive protein (CRP), interleukin-6, and tumor necrosis factor alpha (TNF -a). Patientswere followed up over a total period of 9 ± 3 years from baseline. Results: Increased baseline CRP and its on-treatment decrease were associated with improvement of LVEF (est. coeffi cient per one SD: 1.6; 95% CI : -0.05,3.28; p = 0.056, and -1.80; -3.43, -0.18; p = 0.030, respectively) (-6.83; -11.32; -2.34; p = 0.003, and 5.85; 1.23; -10.46; p = 0.014, respectively). Higher baseline ET-1 and on-treatment increase in TNF-a predicted frequent admissions (> 1) for cardiac complications (odds ratio per one SD: 1.98; p = 0.025, and 2.07, p = 0.021, respectively) (Cardiol J 2013; 20, 2: 144-151)

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Section: Discussionsupporting

confidence: 90%

Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol

Nessler¹,

Nessler²,

Gołębiowska-Wiatrak³

et al. 2013

Cardiol J.

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“…The observed fall in BNP levels is potentially clinically relevant, being similar to that previously observed with angiotensin-converting enzyme inhibitors and with spironolactone. 25,26 We did not measure cardiac chamber sizes or ejection fraction in this study; thus, it is not clear whether this reduction in BNP indicates cardiac remodeling, a reduction in afterload from falling arterial blood pressure, or an effect on myocardial ischemia, but our findings suggest that vitamin D could still have a clinically important effect on the hemodynamic status of patients with heart failure even in the absence of a beneficial effect on exercise capacity. Similar findings have been seen previously when using spironolactone in patients with mild heart failure.…”

Section: Discussionmentioning

confidence: 81%

The Effects of Vitamin D Supplementation on Physical Function and Quality of Life in Older Patients With Heart Failure

Witham

Crighton

Gillespie

et al. 2010

Circ: Heart Failure

202

148

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Background-Low 25-hydroxyvitamin D levels, commonly found in older patients with heart failure, may contribute to the chronic inflammation and skeletal myopathy that lead to poor exercise tolerance. We tested whether vitamin D supplementation of patients with heart failure and vitamin D insufficiency can improve physical function and quality of life. Methods and Results-In a randomized, parallel group, double-blind, placebo-controlled trial, patients with systolic heart failure aged Ն70 years with 25-hydroxyvitamin D levels Ͻ50 nmol/L (20 ng/mL) received 100 000 U of oral vitamin D2 or placebo at baseline and 10 weeks. Outcomes measured at baseline, 10 weeks, and 20 weeks were 6-minute walk distance, quality of life (Minnesota score), daily activity measured by accelerometry, Functional Limitations Profile, B-type natriuretic peptide, and tumor necrosis factor-␣. Participants in the vitamin D group had an increase in their 25-hydroxyvitamin D levels compared with placebo at 10 weeks (22.9 versus 2.3 nmol/L [9.2 versus 0.9 ng/mL]; PϽ0.001) and maintained this increase at 20 weeks. The 6-minute walk did not improve in the treatment group relative to placebo. No significant benefit was seen on timed up and go testing, subjective measures of function, daily activity, or tumor necrosis factor. Quality of life worsened by a small, but significant amount in the treatment group relative to placebo. B-type natriuretic peptide decreased in the treatment group relative to placebo (Ϫ22 versus ϩ78 pg/mL at 10 weeks; Pϭ0.04). Conclusions-Vitamin D supplementation did not improve functional capacity or quality of life in older patients with heart failure with vitamin D insufficiency.

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“…Owing to the improvement in LV hemodynamics, beta-blocker therapy with an ACEI or ARB is likely to reduce NT-proBNP levels over time, but previous results are divergent [10,[28][29][30]. These results might be due to small sample size, variable follow-up time and differences between study populations.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of carvedilol and nebivolol on diastolic functions of the left ventricle in patients with non-ischemic heart failure

et al. 2014

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Background: We investigated whether carvediolol or nebiovolol with vasodilator properties will produce different effects on diastolic function of the left ventricle (LV) in heart failure (HF) with low ejection fraction (EF).Methods: Sixty-one non-ischemic HF patients with EF £ 40% randomly received carvedilol (n = 31, 16 male) or nebivolol (n = 30, 19 DT prolonged (from 184 ± 40 to 218 ± 42 ms vs. from 193 ± 37 to 222 ± 36 ms, p = 0.71). Also, E/Ea ratio significantly decreased in each group (p = 0.01), but it was lower in nebivolol group than carvedilol group at 6 months (10.2 ± 2 vs. 11.8 ± 2, p = 0.41, respectively) and improved functional capacity (p > 0.05). Conclusions: At 6 month follow-up, carvedilol and nebivolol appear to similarly improve LV diastolic functions in non-ischemic HF patients. (Cardiol J 2014; 21, 1: 76-82) male). Clinical and echocardiographic evaluations were performed at baseline, 3 and 6 months after therapy. Mitral inflow velocities (E and A waves), deceleration time of E wave (DT), isovolumetric relaxation time (IVRT), mitral annular velocities (Ea and Aa waves) were evaluated. Mitral E/A and E/Ea ratios were calculated. Results: In carvediolol and nebivolol groups, mitral E/

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Effect of Beta-blockade and ACE Inhibition on B-type Natriuretic Peptides in Stable Patients with Systolic Heart Failure

Cited by 34 publications

References 38 publications

Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol

Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol

The Effects of Vitamin D Supplementation on Physical Function and Quality of Life in Older Patients With Heart Failure

Comparison of the effects of carvedilol and nebivolol on diastolic functions of the left ventricle in patients with non-ischemic heart failure

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