Pharmacological modulation of β-adrenoceptor function in patients with coexisting chronic obstructive pulmonary disease and chronic heart failure

Pharmacology and Therapeutics of Bronchodilators

“…Whatever the case may be, the observation that ␤ 2 -AR agonists may exacerbate heart failure is supported by physiological observations (Matera et al, 2010). ␤ 1 -ARs are down-regulated and desensitized among patients with LV systolic dysfunction, and ␤ 2 -ARs, although desensitized, are found in normal numbers and represent a higher proportion of total ␤-ARs.…”

“…In particular, it remains unknown whether the use of ␤ 2 -AR agonists leads to an increased risk of heart failure and/or it may affect the risk of hospitalization among patients with existing chronic heart failure (CHF) (Matera et al, 2010). When acutely administered, ␤ 2 -AR agonists are efficacious in improving cardiac performance in patients with CHF because they enhance cardiac and stroke volume indexes in a dose-dependent manner (Matera et al, 2010).…”

“…When acutely administered, ␤ 2 -AR agonists are efficacious in improving cardiac performance in patients with CHF because they enhance cardiac and stroke volume indexes in a dose-dependent manner (Matera et al, 2010). For these reasons, ␤ 2 -AR agonists are often used for the short-term enhancement of heart contractility and support of the circulation.…”

“…Although cardioselective ␤-AR blockers have been designed to target ␤ 1 -ARs but avoid ␤ 2 -ARs in the lung and elsewhere, so called cardioselective ␤-AR blockers (such as atenolol and bisoprolol) are only relatively selective and exert significant ␤ 2 -AR antagonism at therapeutic doses, although to a lesser extent than nonselective ␤-AR blockers such as propranolol. Thus, it might be considered counterintuitive to prescribe both ␤-AR blockers and ␤ agonists in the same patient, even when they are targeting different organs (Cazzola et al, 2002c;Matera et al, 2010). In fact, there is some risk that bronchospasm may occur in certain patients and that the bronchodilator response to inhaled ␤ 2 -AR agonists might be impaired with these agents.…”

Effects of olmesartan therapy on the expression of lung adrenoceptors in rats with chronic heart failure

“…[2][3][4][5][6] The enhanced SNS activation in CHF can lead to down-regulation of cardiac β-AR expression. 7 However, there is little research to show that AR expression changes correspondingly under the condition of CHF, or whether olmesartan has an impact on lung AR through interactions between the RAS and the SNS. This study was designed to investigate the effect of olmesartan on heart function, levels of plasma renin activity (PRA) and Ang II, and α 1A -AR, β 1 -AR and β 2 -AR expression in the lungs of rats with CHF.…”