Effects of nebivolol in elderly heart failure patients with or without systolic left ventricular dysfunction: results of the SENIORS echocardiographic substudy

Abstract

In patients with heart failure and advanced systolic LV dysfunction, nebivolol reduces ventricular size and improves EF. The absence of detectable changes with standard echocardiography in patients with predominant diastolic heart failure questions the mechanism of benefit on morbidity/mortality in such patients.

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

“…Patrianakos et al [9] have showed that DT was similarly prolonged with Abdullah Dogan et al, Carvedilol or nebivolol in diastolic dysfunction both study drugs, with earlier improvement with carvedilol. A 12-month nebivolol therapy resulted in a trend toward reduction in mitral E/A ratio and prolongation in DT in elderly HF patients in echocardiographic substudy of SENIORS study [8]. These useful effects may be due to vasodilatory action of both agents.…”

“…These useful effects are frequently attributed to the elevated LVEF due to reduction in LV volumes [8,9,[11][12][13][14].…”

“…They can reverse cardiac remodeling resulting from sympathetic overactivation in HF patients [7][8][9][10][11]. Moreover, they improve symptoms and survival in HF patients [9,[11][12][13][14].…”

Nebivolol: Does the key lie in β3 agonism?

“…These same mechanisms could explain part of the benefit observed in the SENIOR study in patients with chronic heart failure [65].…”

“…Outcomes and Rehospitalization in Seniors with Heart Failure) [65] enrolled patients with heart failure, and established as inclusion criteria that the patients were 70 years old or older and incorporated a high percentage of women and patients with preserved systolic function. It showed a reduction of 14% in the mortality from all causes, and there were no more adverse effects than with placebo.…”