Carvedilol and metoprolol are both able to preserve myocardial function in type 2 diabetes

Abstract

Purpose Increasing cohorts of patients present with diabetic cardiomyopathy, and with no targeted options, treatment often rely on generic pharmaceuticals such as β‐blockers. β‐blocker efficacy is heterogenous, with second generation β‐blocker metoprolol selectively inhibiting β1‐AR, while third generation β‐blocker carvedilol has α1‐AR inhibition, antioxidant, and anti‐apoptotic actions alongside nonselective β‐AR inhibition. These additional properties have led to the hypothesis that carvedilol may improve cardiac contractility in the diabetic heart to a greater extent than metoprolol. The present study aimed to compare the efficacy of metoprolol and carvedilol on myocardial function in animal models and cardiac tissue from patients with type 2 diabetes and preserved ejection fraction. Methods Echocardiographic examination of cardiac function and assessment of myocardial function in isolated trabeculae was carried out in patients with and without diabetes undergoing coronary artery bypass grafting (CABG) who were prescribed metoprolol or carvedilol. Equivalent measures were undertaken in Zucker Diabetic Fatty (ZDF) rats following 4 weeks treatment with metoprolol or carvedilol. Results Patients receiving carvedilol compared to metoprolol had no difference in cardiac function, and no difference was apparent in myocardial function between β‐blockers. Both β‐blockers similarly improved myocardial function in diabetic ZDF rats treated for 4 weeks, without significantly affecting in vivo cardiac function. Conclusions Metoprolol and carvedilol were found to have no effect on cardiac function in type 2 diabetes with preserved ejection fraction, and were similarly effective in preventing myocardial dysfunction in ZDF rats.

Effects of Carvedilol on Blood Pressure, Blood Sugar, and Blood Lipids in Elderly Patients with Refractory Hypertension

“…Our study found that fasting glucose, insulin, TG, CHO, and LDL-C were significantly higher in the observation group than in the comparison group; however, ISI and HDL-C were significantly lower in the observation group than in the comparison group, and the comparative differences were all statistically significant. We know that traditional β -blockers can lead to an increase in TG and CHO levels as well as abnormalities in glucose tolerance and increased insulin resistance while exerting therapeutic effects [ 28 ]. Therefore, improving 3-blockers and improving lipid and glucose metabolism become essential.…”

Inotropic and lusitropic, but not arrhythmogenic, effects of adipocytokine resistin on human atrial myocardium

“…Trabecula isolation. Myocardial function was assessed in human RAA trabeculae, which were isolated and mounted in a custom-built organ bath as described previously (6,18). Trabeculae were superfused with a 37 C 1 mM Ca 2+ KHB (components as above) that was continuously oxygenated with carbogen (95% O 2 -5% CO 2 ).…”

Beta-blockers used in cardiac failure and blood glucose level impairment - a literature review

“…Biorąc powyższe pod uwagę, w leczeniu pacjentów zarówno z zaburzeniami glikemii, jak i HF ważne jest stosowanie beta-adrenolityków przy zachowaniu dobrej kontroli glikemii, ponieważ ma to kluczowe znaczenie dla poprawy wyników klinicznych [15], [16], [17]. Wiadome jest, że starsze β-blokery w dawkach leczniczych, mogą prowadzić do wzrostu stężenia glukozy we krwi, upośledzenia tolerancji glukozy i zwiększonej insulinooporności [37], [54]. Dlatego pomimo powszechnej akceptacji potencjalnie korzystnych właściwości leków beta-adrenolitycznych w HF uważano, że cukrzyca jest względnym przeciwwskazaniem do stosowania leków z tej grupy.…”