© 2003 European Society of Cardiology
β-Blocker treatment of patients with diastolic heart failure and arterial hypertension. A prospective, randomized, comparison of the long-term effects of atenolol vs. nebivolol
Cattedra di Cardiologia, Università di Brescia c/o Spedali Civili, P.zza Spedali Civili, 25100 Brescia, Italy
* Corresponding author. Tel.: +39-30-307221; fax: +39-30-3700359. E-mail address: savina.nodari{at}tin.it
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Abstract |
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We compared the effects of 6 months administration of atenolol or nebivolol on resting and exercise hemodynamic parameters and maximal exercise capacity, in 26 patients with hypertension and left ventricular (LV) diastolic dysfunction (ejection fraction >50%, end-diastolic diameter <60 mm and increased pulmonary wedge pressure at rest and/or at peak exercise). Both atenolol and nebivolol administration was associated with a significant decrease in the resting and peak exercise heart rate and blood pressure and in LV mass, with an increase in the E/A ratio. This latter effect was greater with nebivolol. Nebivolol was associated with an increase in the peak VO2, VO2 at the anaerobic threshold and with a decrease in the VE/VCO2 ratio. With regards to the hemodynamic parameters, compared to patients on atenolol, those on nebivolol showed a lower reduction in the cardiac index, a greater increase in the stroke volume index and a decline in the mean pulmonary artery pressure and pulmonary wedge pressure, both at rest and peak exercise. Thus, although the two β-blockers have a similar antihypertensive action, nebivolol administration was associated with a greater hemodynamic improvement, compared to atenolol.
Key Words: β-Blockers • Diastolic function • Heart failure
Received August 21, 2002; Revised January 17, 2003; Accepted April 23, 2003
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