Beta-blocker treatment of dilated cardiomyopathy. Beneficial effect of carteolol in mice.

Abstract

BACKGROUND The effects of carteolol, a nonselective beta-adrenergic receptor blocker with intrinsic sympathomimetic activity, were compared with those of metoprolol in a murine model of viral myocarditis and dilated cardiomyopathy caused by encephalomyocarditis virus. METHODS AND RESULTS In the acute experiment, BALB/c and DBA/2 mice were inoculated with encephalomyocarditis virus. BALB/c mice were then given carteolol at 1 (n = 10), 10 (n = 10), 30 (n = 11), or 100 mg/kg (n = 9) daily, and DBA/2 mice were given carteolol at 1 (n = 9) or 10 mg/kg (n = 9) daily starting the day of inoculation. Controls were given distilled water (n = 23 for BALB/c mice and n = 8 for DBA/2 mice). BALB/c mice were killed on day 7, and DBA/2 mice were killed on day 14. In the subacute experiment, DBA/2 mice were inoculated with the virus and then given carteolol at 1 (n = 12) or 10 mg/kg (n = 16), or distilled water (n = 27) daily, starting on day 14. Mice were killed on day 28. Virus replication, murine survival, heart weight to body weight ratio, and histopathological findings were similar in each group in the acute and subacute experiments. In the chronic experiment, DBA/2 mice were inoculated with the virus and were then given carteolol at 1 (n = 13) or 10 mg/kg (n = 9), metoprolol at 30 mg/kg (n = 9), or distilled water (n = 31) daily, starting on day 14. Mice were killed on day 104. Heart weight to body weight ratio and histopathological scores were significantly lower in mice given carteolol than in the infected control group. Furthermore, left ventricular cavity dimension, left ventricular wall thickness, and myocardial fiber diameter of the left ventricle were significantly reduced in mice given carteolol compared with the control group. Metoprolol did not cause any significant changes compared with the control group. CONCLUSIONS This study suggests that carteolol prevents the development of myocardial lesions similar to those in dilated cardiomyopathy after myocarditis in the chronic stage.

Myocarditis-A Quick Review

“…31 The use of nonsteroidalantiinflammatory drugs was associated with increased mortality. 32,33,34 Taken together, these data support the application of the current heart-failure guidelines to patients with heart failure from myocarditis.…”

Propranolol ameliorates and epinephrine exacerbates progression of acute and chronic viral myocarditis

“…A few studies have demonstrated beneficial effects of ␤-blockers in viral myocarditis. Tominaga et al (36) reported that the ␤-blocker carteolol had beneficial effects on dilated cardiomyopathy induced by EMCV but had no effect on the early stage of myocarditis. Nishio et al (30) reported that carvedilol improved the survival of mice infected with EMCV.…”

Nifedipine inhibits the activation of inflammatory and immune reactions in viral myocarditis

“…An α-adrenergic blocking agent, and a β-adrenergic agent did not have a beneficial effect on the same animal model of viral myocarditis (Matsumori 1993;Tominaga et al 1991). Therefore, left ventricular unloading did not reduce myocardial injury.…”