Hemodynamic effects of nebivolol at rest and on exertion in patients with heart failure.
Nebivolol is a novel B-1-adrenoceptor-blocking drug with an unusual hemodynamic profile unlike classical B-blockers. In dogs and in healthy volunteers it decreases blood pressure and heart rate but improves left ventricular function. The authors studied 10 male patients with coronary artery disease and heart failure (ejection fraction mean = 46%). A Swan-Ganz catheter was placed into the pulmonary artery, and the mean blood pressure, the heart rate, the pulmonary artery pressure, the pulmonary wedge pressure, the right atrial pressure, the cardiac output, and the stroke volume were measured at rest and on exertion before and after seven days' treatment with oral nebivolol (5 mg/day). While the blood pressure and the heart rate decreased significantly, the pulmonary artery and wedge pressures, as well as the right atrial pressure and the cardiac output, did not change during treatment. The stroke volume increased significantly. The maintained cardiac output cannot be explained by any changes in preload or afterload; instead a positive inotropic mechanism must be assumed. Unlike other B-blockers it seems to be possible to treat patients with heart failure with nebivolol without causing the hemodynamic situation to deteriorate.
Brune
S
S
Department of Cardiology, University of Göttingen, West Germany.
Schmidt
T
T
Tebbe
U
U
Kreuzer
H
H
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D001578:Benzopyrans / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D003327:Coronary Disease / Q000188:drug therapy; D004983:Ethanolamines / Q000494:pharmacology* / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol; D005082:Physical Exertion / Q000502:physiology; D016277:Ventricular Function, Left / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol