[Influence of the beta-blocker nebivolol on left ventricular function in patients with chronic heart failure].
BACKGROUND
Sympathetic activity is a significant predictor of a poor prognosis in heart failure. beta-blockers such as carvedilol, metoprolol or bisoprolol have been shown to improve the prognosis of patients with heart failure.


OBJECTIVE
This pilot study examined the tolerability and effect of the new beta-blocker nebivolol on left ventricular ejection fraction in patients with chronic heart failure.


METHODS
Twelve patients with an ejection fraction of 13-39% were included into a double-blind, placebo-controlled, randomized trial with nebivolol on top of a standard therapy. Exercise time, heart rate, left ventricular function, and tolerability were examined at baseline and after 3 months of orally administered nebivolol (2.5 mg and 5 mg, n = 6) or placebo (n = 6).


RESULTS
Nebivolol was well tolerated and NYHA stage improved in four patients. Heart rate decreased while the maximal exercise duration and performance remained stable. Left ventricular function improved (ejection fraction: increase from 29.8 +/- 10.66% to 41.2 +/- 10.53%; p = 0.007) after 12 weeks of nebivolol whereas placebo did not improve cardiac function statistically significant. Left ventricular endsystolic diameter decreased from 56.5 +/- 9.40 mm to 50.2 +/- 9.43 mm in the nebivolol group (p < or = 0.02).


CONCLUSIONS
These data indicate that nebivolol might improve cardiac function in patients with chronic heart failure.
Wolf
Sabine C
SC
Medizinische Klinik III, Universität Tübingen.
Buck-Müller
Nina
N
Görner
Sandra
S
Risler
Teut
T
Brehm
Bernhard R
BR
D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001578:Benzopyrans / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D004562:Electrocardiography; D004983:Ethanolamines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol; D010865:Pilot Projects; D010919:Placebos; D013318:Stroke Volume; D013997:Time Factors; D014665:Vasodilator Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects*
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D010919:Placebos; D014665:Vasodilator Agents; D000068577:Nebivolol