Which Beta-Blocker is Most Effective in Heart Failure?

Remme, Willem J.

doi:10.1007/s10557-010-6247-7

Cited by 22 publications

(26 citation statements)

References 68 publications

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“…Beta-blockers reduce heart rate and prolong the diastolic period, thereby decreasing both oxygen consumption of myocardium and increasing oxygen supply to myocardium. Consequently, they can improve myocardial relaxation or diastolic functions and metabolism [15,21].…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

“…Moreover, they improve symptoms and survival in HF patients [9,[11][12][13][14]. However, there is uncertainity whether their fovarable effects will similarly produce clinical benefit, and carvediolol may be preferred to nebivolol in HF patients [15].…”

Section: Introductionmentioning

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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“…Carvedilol, a nonselective beta blocker with antioxidant and -adrenergic receptor blocking ('alpha-blocking') activities, is one of the most effective beta blockers in reducing ventricular tachyarrhythmias and mortality in individuals with HF [76][77][78][79][80]. The reports on the effect of carvedilol on NO production are scarce yet controversial.…”

Section: No In Chf-effects Of Carvedilolmentioning

confidence: 99%

Nitric Oxide and its Role in Cardiovascular Diseases

Dobutović¹

2011

TONOJ

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Nitric oxide synthases (NOS) are the enzymes responsible for nitric oxide (NO) generation. NO is a free radical which reacts with various molecules to cause multiple biological effects. It is clear that the generation and actions of NO under physiological and pathophysiological conditions are exquisitely regulated and extend to almost every cell type and function within the circulation. While the molecule mediates many physiological functions, an excessive presence of NO is toxic to cells. The enzyme NOS, constitutively or inductively, catalyses the production of NO in several biological systems. NO is derived not only from NOS isoforms but also from NOS-independent sources. In mammals, to date, three distinct NOS isoforms have been identified: neuronal NOS (nNOS), inducible NOS (iNOS), and endothelial NOS (eNOS). The molecular structure, enzymology and pharmacology of these enzymes have been well defined, and reveal critical roles for the NOS system in a variety of important physiological processes. This review focuses on recent advances in the understanding of the interactions between NOS enzymes and pathophysiology of cardiovascular diseases (CVD) and the role of NO agonists as potential therapeutic agents in treatment of CVD.

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“…On the other hand, it is a disputable subject as to which beta-blocker is more effective in HF treatment and whether carvedilol or nebivolol should be a first-choice agent (15). This issue is important for clinicians, since beta-blockers have different properties.…”

Section: Introductionmentioning

confidence: 99%

“…This issue is important for clinicians, since beta-blockers have different properties. Preclinical studies point out a trend toward carvedilol or nebivolol due to their effects on cardiac remodeling and their pleiotropic properties (15, 16). …”

Section: Introductionmentioning

confidence: 99%

Carvedilol and nebivolol improve left ventricular systolic functions in patients with non-ischemic heart failure

Karabacak¹,

Doğan²,

Tayyar³

et al. 2015

Anatol J Cardiol

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Objective:It is unclear whether carvedilol and nebivolol produce different effects on short-term left ventricle (LV) systolic function in heart failure (HF). These drugs could improve systolic and diastolic functions of the LV. Thus, we aimed to compare their effects on LV systolic functions in patients with non-ischemic HF.Methods:This study included 61 symptomatic non-ischemic HF patients with low ejection fraction (EF) (EF≤40%) between September 2008 and November 2010. The patients were randomized to carvedilol (n=31, 16 males) or nebivolol (n=30, 19 male). They were evaluated clinically and echocardiographically at baseline and 3 and 6 months after target dose; 42% of patients in the carvedilol group and 47% in the nebivolol group achieved the target dose before randomization. LV systolic functions were evaluated with ventricle diameters, EF, ejection time (ET), isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), and myocardial performance index (MPI).Results:At 6 months, carvedilol and nebivolol similarly improved EF (from 33±4% to 36±5%, p<0.01 and from 34±5% to 37±5%, p<0.01, inter-group p=0.30, respectively) and MPI (from 0.71±0.10 to 0.53±0.07, p<0.01 and from 0.69±0.13 to 0.52±0.08, p<0.01, intergroup p=0.45, respectively). LV diameter was reduced by a similar extent in both groups. In each group, IVCT and IVRT were significantly shortened and ET was prolonged, but there was no inter-group difference. Functional capacity improved similarly (from NYHA Class II-III to Class I-0) in both groups, as did heart rate and blood pressure. Reduction of pro-B-type natriuretic peptide levels was also comparable in both groups (p=0.41).Conclusion:Carvedilol and nebivolol can similarly improve LV systolic functions in non-ischemic HF patients.

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Which Beta-Blocker is Most Effective in Heart Failure?

Cited by 22 publications

References 68 publications

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

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

Nitric Oxide and its Role in Cardiovascular Diseases

Carvedilol and nebivolol improve left ventricular systolic functions in patients with non-ischemic heart failure

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