1. Carvedilol and metoprolol are both able to preserve myocardial function in type 2 diabetes.
- Author
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Bussey CT, Babakr AA, Iremonger RR, van Hout I, Wilkins GT, Lamberts RR, and Erickson JR
- Subjects
- Aged, Animals, Carvedilol administration & dosage, Coronary Artery Bypass methods, Diabetes Mellitus, Type 2 physiopathology, Disease Models, Animal, Female, Heart physiopathology, Humans, Male, Metoprolol administration & dosage, Middle Aged, Rats, Zucker, Treatment Outcome, Adrenergic beta-1 Receptor Antagonists therapeutic use, Carvedilol therapeutic use, Diabetes Mellitus, Type 2 drug therapy, Heart drug effects, Metoprolol therapeutic use
- Abstract
Purpose: Increasing cohorts of patients present with diabetic cardiomyopathy, and with no targeted options, treatment often rely on generic pharmaceuticals such as β-blockers. β-blocker efficacy is heterogenous, with second generation β-blocker metoprolol selectively inhibiting β
1 -AR, while third generation β-blocker carvedilol has α1 -AR inhibition, antioxidant, and anti-apoptotic actions alongside nonselective β-AR inhibition. These additional properties have led to the hypothesis that carvedilol may improve cardiac contractility in the diabetic heart to a greater extent than metoprolol. The present study aimed to compare the efficacy of metoprolol and carvedilol on myocardial function in animal models and cardiac tissue from patients with type 2 diabetes and preserved ejection fraction., Methods: Echocardiographic examination of cardiac function and assessment of myocardial function in isolated trabeculae was carried out in patients with and without diabetes undergoing coronary artery bypass grafting (CABG) who were prescribed metoprolol or carvedilol. Equivalent measures were undertaken in Zucker Diabetic Fatty (ZDF) rats following 4 weeks treatment with metoprolol or carvedilol., Results: Patients receiving carvedilol compared to metoprolol had no difference in cardiac function, and no difference was apparent in myocardial function between β-blockers. Both β-blockers similarly improved myocardial function in diabetic ZDF rats treated for 4 weeks, without significantly affecting in vivo cardiac function., Conclusions: Metoprolol and carvedilol were found to have no effect on cardiac function in type 2 diabetes with preserved ejection fraction, and were similarly effective in preventing myocardial dysfunction in ZDF rats., (© 2020 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.)- Published
- 2020
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