Medium-term effects of beta-blockade on left ventricular mechanics: A double-blind, placebo-controlled comparison of nebivolol and atenolol in patients with ischemic left ventricular dysfunction

Rousseau, Michel F.; Chapelle, F.; Eyll, Christian van; Stoleru, L.; Hager, David; Nueten, Luc Van; Pouleur, H.

doi:10.1016/s1071-9164(96)80004-2

Cited by 38 publications

(24 citation statements)

References 32 publications

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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%

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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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Section: Discussionmentioning

confidence: 99%

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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“…This was a study which showed positive effects in diastolic dysfunction. [33][34][35] Another important contradicting study that showed less significant effects is the ELANDD (Effects of the long-term administration of nebivolol on the clinical symptoms, exercise capacity, and left ventricular function of patients with diastolic dysfunction). In this study, 116 subjects with diastolic heart failure or with preserved ejection fraction, who were in the NYHA functional class II-III, whom left ventricular ejection fraction was >45% and who showed echo-doppler signs of LV diastolic dysfunction, were randomized to placebo or nebivolol treatment for 6 months.…”

Section: Nebivolol Therapy In Diastolic Dysfunctionmentioning

confidence: 99%

Nebivolol: An Appealing, Awaited and Nitric Oxide Potentiator Drug for the Treatment of Heart Failure

Saini¹,

Wal²,

Verma³

et al. 2018

JYP

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Nebivolol is a third generation beta-blocker that possesses the highest selectivity for beta-1 receptors than beta-2 receptors than any other beta blocker in its class. Long-term therapy of nebivolol, in clinical trials, has been found to be very effective in increasing the left ventricular ejection fraction, reducing all-cause mortality, and reducing the New York Heart Association (NYHA) class of heart failure. The novelty of nebivolol exists in its unique nitric oxide potentiating effects in the myocardial and endothelial cells by the activation of beta-3 adrenergic receptors by which it produces most of its actions. It produces many useful effects and helps to abate the disease progression and prolongs the survival. In many clinical studies, it has been found to be safe and well tolerated. A literature search was made on PubMed database with the keywords: "Heart failure" , "Nebivolol" , and "beta-blocker" . A total of 176 articles were found and were the combination of review articles and research articles. A further selection of articles was made by the exclusion of non-relevant articles to achieve the objective of this review. It is approved for the treatment of hypertension in the United States and is under review by the federal agency, United States Food and Drugs Administration for the treatment of heart failure. This article sole intention is to review all the clinically important aspects of nebivolol on the basis of which nebivolol can be definitely considered for its inclusion in the drug therapy list for heart failure which will ease the individualization of drug therapy. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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“…Entscheidend für die Bewertung der hämodynamischen Effekte von Nebivolol ist der Einfluss auf den linksventrikulären enddiastolischen Druck (LVEDP) sowie auf die Prognose von herzinsuffizienten Patienten: Zur Prognoseverbesserung bei Herzinsuffizienz liegen für Nebivolol bislang keine Daten vor. Jedoch führt Nebivolol bei Patienten mit chronischer Herzinsuffizienz auf dem Boden einer dilatativen (DCM) oder ischämischen Kardiomyopathie (ICM) zu einer signifikanten Senkung des LVEDP [3,4]. Dieser Effekt lässt sich durch die Verbesserung der systolischen Funktion und durch die vasodilatierenden Eigenschaften dieser Substanz erklären, die zu einer Senkung der Vor-und Nachlast füh-ren.…”

Section: Unter Dem Betablocker Nebivolol (Nebilet®) Kommt Es Neben Eiunclassified

“…Dieser Effekt lässt sich durch die Verbesserung der systolischen Funktion und durch die vasodilatierenden Eigenschaften dieser Substanz erklären, die zu einer Senkung der Vor-und Nachlast füh-ren. Darüber hinaus trägt die Senkung der Herzfrequenz und die Verbesserung der Druck-Volumen-Beziehung während der Diastole zu einer Verbesserung der diastolischen Füllung bei [4]. Dadurch kommt es zu einer Verschiebung der Frank-Starling-Kurve in einen günstige-ren Bereich, in dem das Schlagvolumen im Vergleich zum Herzfrequenzabfall überproportional ansteigt, sodass netto ein Anstieg des Herzzeitvolumens resultiert [1].…”

Section: Unter Dem Betablocker Nebivolol (Nebilet®) Kommt Es Neben Eiunclassified

Hämodynamische Wirkungen des Betablockers Nebivolol

Rosenkranz

Erdmann

2003

Internist

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FrageUnter dem Betablocker Nebivolol (Nebilet®) kommt es neben einer leichten Herzfrequenzsenkung (minus 10%) zu einer deutlichen Zunahme des Schlagvolumens (plus 20%), so dass, abweichend von allen anderen Betablockern, das Herzminutenvolumen um etwa 10% ansteigt. Die Herstellerfirma wertet diesen Effekt als Verbesserung der linksventrikulären Funktion. Eine Erhöhung des Herzzeitvolumens bedeutet aber eine erhöhte Volumenarbeit des Herzmuskels. Kann diese Situation als uneingeschränkt positiv bewertet werden? ⚉ AntwortDieser Effekt muss sicherlich differenziert und in Abgängigkeit des Grundzustands des Herzmuskels sowie der ihn versorgenden Gefäße betrachtet werden.Bei Patienten mit chronischer Herzinsuffizienz kommt es in der Regel zu einer Vergröße-rung des linken Ventrikels, zu einer erhöhten Wandspannung und zu einer Erhöhung des linksventrikulären enddiastolischen Druckes (LVEDP). Therapeutisch versucht man, durch eine Senkung der Nachlast (z. B. durch ACE-Hemmer) eine Verbesserung des linksventrikulären Auswurfs gegen einen erniedrigten peripheren Widerstand zu erzielen, was sekundär zu einer Senkung des LVEDP

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Medium-term effects of beta-blockade on left ventricular mechanics: A double-blind, placebo-controlled comparison of nebivolol and atenolol in patients with ischemic left ventricular dysfunction

Cited by 38 publications

References 32 publications

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

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

Nebivolol: An Appealing, Awaited and Nitric Oxide Potentiator Drug for the Treatment of Heart Failure

Hämodynamische Wirkungen des Betablockers Nebivolol

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