Long-term effect of atenolol on ejection fraction, symptoms, and exercise variables in patients with advanced left ventricular dysfunction

Hülsmann, Martin; Sturm, Barbara; Pacher, Richard; Berger, Rudolf; Bojic, Anja; Frey, Bernhard; Stanek, Brigitte

doi:10.1016/s1053-2498(01)00341-2

Cited by 13 publications

(17 citation statements)

References 23 publications

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“…These observations provide evidence that both We have demonstrated that treatment of 3 weeks infarcted rats with 20 and 75 mg/kg doses (given daily via a gastric tube) of both atenolol and propranolol attenuated the MIinduced cardiac dysfunction and LV dilatation without any effect on the infarct size. These observations support the findings of other investigators [13][14][15][16] who have shown that both atenolol and propranolol exert beneficial effects in patients with CHF. Likewise, both selective and non-selective b-AR antagonists including metoprolol and carvedilol have been reported to improve cardiac function and prevent LV remodeling in CHF [6,[8][9][10].…”

Section: Discussionsupporting

confidence: 92%

“…In view of the diverse nature of b-ARs in the myocardium and their differential regulation in CHF [6,11], various investigators have shown that selective b-AR antagonists such as metoprolol and atenolol as well as non-selective b-AR antagonists including carvedilol and propranolol attenuate left ventricular (LV) remodeling in patients with CHF [12][13][14][15][16]. The beneficial effects of these agents on cardiac function and remodeling are considered to be due to their actions on the b 1 -ARs in the myocardium [17].…”

Section: Introductionmentioning

confidence: 99%

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Amelioration of Cardiac Remodeling in Congestive Heart Failure by β-Adrenoceptor Blockade is Associated with Depression in Sympathetic Activity

et al. 2009

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This study investigated whether improvement in cardiac function and attenuation of cardiac remodeling by some beta-adrenoceptor (beta-AR) antagonists were associated with a depression in sympathetic activity in congestive heart failure (CHF) due to myocardial infarction (MI). Although cardiac dysfunction, hypertrophy and dilatation as well as increased plasma level of catecholamines are known to occur in CHF, the relationship between these parameters is poorly understood. Three weeks after occlusion of the coronary artery, rats were treated daily with 20 and 75 mg/kg of either atenolol or propranolol for 5 weeks. Sham-operated rats served as controls. Both atenolol and propranolol at 20 and 75 mg/kg doses attenuated the MI-induced cardiac hypertrophy, increases in left ventricular (LV) end-diastolic pressure, LV end-systolic volume and LV end-diastolic volume as well as depressions in LV systolic pressure, LV fractional shortening and cardiac output. PR interval was decreased and QT( c ) interval was increased in CHF; these alterations were ameliorated by both atenolol and propranolol. The increased level of plasma epinephrine in CHF was also depressed by both low and high doses of atenolol and propranolol whereas the increased level of plasma norepinephrine was reduced by high but not low doses of these drugs. The results indicate that the beneficial effects of beta-AR antagonists on cardiac remodeling and heart dysfunction in CHF may be due to the blockade of beta-ARs in the myocardium and a depression in the sympathetic activity.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Amelioration of Cardiac Remodeling in Congestive Heart Failure by β-Adrenoceptor Blockade is Associated with Depression in Sympathetic Activity

et al. 2009

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“…In general, β 1 -selective adrenergic receptor blockers have been reported to exert positive effects on cardiac function and remodeling in patients with HF [4, 5, 7,12,13,14,15]. However, evidence from experimental studies suggests that these agents differ with respect to the mechanisms through which such improvements are achieved.…”

Section: Discussionmentioning

confidence: 99%

“…To date, only 4 β-blockers, the nonselective β 1 -/β 2 -/α 1 -blocker carvedilol and the selective β 1 -blockers controlled release/extended release (CR/XL) metoprolol succinate, bisoprolol and, more recently, nebivolol, have been shown to be beneficial in large-scale controlled randomized clinical trials and consequently approved for the treatment of HF [1,2,3]. Atenolol, a selective β 1 -blocker, is currently approved as an antihypertensive [8] and anti-ischemic drug [9], but is commonly prescribed ‘off-label’ in patients with HF [10, 11], despite the absence of evidence-based efficacy data in this patient population based on the assumption that all β-blockers share the same salutary effects in the treatment of HF [12,13,14,15]. …”

Section: Introductionmentioning

confidence: 99%

Atenolol Is Inferior to Metoprolol in Improving Left Ventricular Function and Preventing Ventricular Remodeling in Dogs with Heart Failure

Zacà¹,

Rastogi²,

Mishra³

et al. 2008

Cardiology

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Objectives: β-Blockers are standard therapy for patients with heart failure (HF). This study compared the effects of chronic monotherapy with 2 different β₁-selective adrenoceptor blockers, namely atenolol and metoprolol succinate, on left ventricular (LV) function and remodeling in dogs with coronary microembolization-induced HF [LV ejection fraction (EF) 30–40%]. Methods: Twenty HF dogs were randomized to 3 months of therapy with atenolol (50 mg once daily, n = 6), metoprolol succinate (100 mg, once daily, n = 7) or to no therapy (control, n = 7). LV EF and volumes were measured before initiating therapy and after 3 months of therapy. The change (Δ) in EF and volumes between measurements before and after therapy was calculated and compared among study groups. Results: In controls, EF decreased and end-systolic volume increased. Atenolol prevented the decrease in EF and the increase in ESV. In contrast, metoprolol succinate significantly increased EF and decreased end-systolic volume. ΔEF was significantly higher and Δend-systolic volume significantly lower in metoprolol succinate-treated dogs compared to atenolol-treated dogs (EF: 6.0 ± 0.86% vs. 0.8 ± 0.85%, p < 0.05; end-systolic volume: –4.3 ± 0.81 ml vs. –1 ± 0.52 ml, p <0.05). Conclusions: In HF dogs, chronic therapy with atenolol does not elicit the same LV function and remodeling benefits as those achieved with metoprolol succinate.

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“…Consequently, it is contraindicated in asthma (58 -60). Atenolol has had limited evaluation in patients with heart failure in two small studies (61,62). However, it is not approved for use in heart failure, and until large trials demonstrate reduced mortality, only approved betablockers should be used for this indication (55).…”

Section: Dose Considerations For Cardioselective Beta-blockers In Manmentioning

confidence: 99%

Cardioselective Beta‐Blockers in Patients with Asthma and Concomitant Heart Failure or History of Myocardial Infarction: When Do Benefits Outweigh Risks?

et al. 2003

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Long-term effect of atenolol on ejection fraction, symptoms, and exercise variables in patients with advanced left ventricular dysfunction

Cited by 13 publications

References 23 publications

Amelioration of Cardiac Remodeling in Congestive Heart Failure by β-Adrenoceptor Blockade is Associated with Depression in Sympathetic Activity

Amelioration of Cardiac Remodeling in Congestive Heart Failure by β-Adrenoceptor Blockade is Associated with Depression in Sympathetic Activity

Atenolol Is Inferior to Metoprolol in Improving Left Ventricular Function and Preventing Ventricular Remodeling in Dogs with Heart Failure

Cardioselective Beta‐Blockers in Patients with Asthma and Concomitant Heart Failure or History of Myocardial Infarction: When Do Benefits Outweigh Risks?

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