Protective effects of nebivolol against anthracycline-induced cardiomyopathy: A randomized control study

Myocardial Protection During Cardiotoxic Chemotherapy

“…In 2 studies performed with carvedilol, prevention of LVEF decline 72 and of LV fractional shortening and global peak strain rate decline 73 were observed (Table 2). Nebivolol 74 but not metoprolol 67 has been reported to prevent LVEF decline in small trials. Ongoing placebo-controlled studies are testing the effect of carvedilol (http://www.clinicaltrials.gov; NCT01724450), carvedilol versus lisinopril (NCT01009918), bisoprolol versus perindopril (NCT01016886), and metoprolol versus candesartan (NCT01434134) in patients treated with trastuzumab.…”

“…76 Finally, a study has recently reported the preventive effects of spironolactone on anthracycline-induced myocardial toxicity in patients with breast cancer. 77 Important limitations of all of these studies [67][68][69][70][71][72][73][74][75][76][77][78] include the small number of patients treated, differences in study design, varying malignancies being studied and chemotherapy regimens used, and short follow-up times. In addition, in most studies, the mortality rate was lower than expected, and the reported beneficial effects on the incidence of HF and LVEF decline did not translate to lower mortality ( Table 2).…”

β-Adrenergic Blockade for Anthracycline- and Trastuzumab-Induced Cardiotoxicity

“…A recent small study evaluated the effects of concomitant nebivolol in 45 patients with breast cancer and found that LV dimensions and ejection fraction did not change after 6 months in the nebivolol group but were worse in those treated with placebo (P=0.01). 17 NT-pro-brain natriuretic peptide levels also remained unchanged at 6 months compared with baseline in the nebivolol group but were significantly increased with placebo (P=0.01). 17 Although these results are encouraging, it remains unclear whether prophylactic β-blocker use reduces the incidence of symptomatic HF in patients undergoing anthracycline-based chemotherapy.…”

Possibilities of Ivabradine, a Selective Inhibitor of Ion F-Channels of Sinus Node, in Prevention of Anthracycline Cardiotoxicity in Patients With Breast Cancer

“…Однако необходимо констати-ровать, что доказательная база для экстраполяции об-щепринятых рекомендаций по лечению больных с ХСН на пациентов с антрациклиновой кардиомиопатией весьма ограничена. Имеются лишь единичные иссле-дования по оценке эффективности применения инги-биторов АПФ, а также комбинации ингибиторов АПФ с бета-адреноблокаторами, в которых продемонстри-ровано клиническое улучшение пациентов с антра-циклиновой кардиомиопатией на фоне этой терапии, однако значимого влияния на прогноз при этом от-мечено не было [14][15][16][17][18][19][20]. Также есть сведения о при-менении в качестве кардиопротективных препаратов на фоне терапии антрацаклинами сартанов, статинов, антагонистов минералокортикоидных рецепторов, метформина [21].…”