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Beneficial effects of beta-blockers on left ventricular function and cellular energy reserve in patients with heart failure.
- Source :
-
Fundamental & clinical pharmacology [Fundam Clin Pharmacol] 2013 Aug; Vol. 27 (4), pp. 455-64. Date of Electronic Publication: 2012 Feb 09. - Publication Year :
- 2013
-
Abstract
- Beta-blockers have been shown to improve left ventricular (LV) function in patients with heart failure. The aim of this study is to non-invasively assess, by means of in vivo 31P-magnetic resonance spectroscopy (31P-MRS), the effects of beta-blockers on LV cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart failure. Ten heart failure patients on full medical therapy were beta-blocked by either carvedilol or bisoprolol. Before and after 3 months of treatment, exercise testing, 2D echocardiography, MRS, New York Heart Association (NYHA) class, ejection fraction (EF), maximal rate-pressure product and exercise metabolic equivalent system (METS) were evaluated. Relative concentrations of PCr and ATP were determined by cardiac 31P-MRS. After beta-blockade, NYHA class decreased (from 2.2 ± 0.54 to 1.9 ± 0.52, P = 0.05), whereas EF (from 33 ± 7 to 44 ± 6%, P = 0.0009) and METS (from 6.74 ± 2.12 to 8.03 ± 2.39, P = 0.01) increased. Accordingly, the mean cardiac PCr/ATP ratio increased by 33% (from 1.48 ± 0.22 to 1.81 ± 0.48, P = 0.03). Beta-blockade-induced symptomatic and functional improvement in patients with heart failure is associated to increased PCr/ATP ratio, indicating preservation of myocardial high-energy phosphate levels.<br /> (© 2012 The Authors Fundamental and Clinical Pharmacology © 2012 Société Française de Pharmacologie et de Thérapeutique. Published by John Wiley & Sons Ltd.)
- Subjects :
- Adenosine Triphosphate metabolism
Aged
Bisoprolol therapeutic use
Carbazoles therapeutic use
Carvedilol
Echocardiography methods
Energy Metabolism
Female
Heart Failure metabolism
Heart Failure physiopathology
Humans
Magnetic Resonance Spectroscopy methods
Male
Propanolamines therapeutic use
Adrenergic beta-Antagonists therapeutic use
Heart drug effects
Heart Failure drug therapy
Ventricular Function, Left drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1472-8206
- Volume :
- 27
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Fundamental & clinical pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 22320703
- Full Text :
- https://doi.org/10.1111/j.1472-8206.2012.01029.x