title: [Assessment of the efficacy of bisoprolol administration by cardiopulmonary exercise testing in patients with heart failure].
abstract: OBJECTIVE
  It is well known that long-term therapy with beta-blockers reduces morbidity and mortality, improves left ventricular function in patients with heart failure. However the effect of beta-blockade on exercise tolerance in patients with heart failure remains unclear. In the present study we evaluated effects of the addition of bisoprolol to standart therapy with a diuretic and an angiotensin converting enzyme (ACE) inhibitor on exercise capacity in patients with chronic heart failure.
  
  
  METHODS
  We enrolled 52 patients (mean age 59+/-11 years) with stable, mild to moderate chronic heart failure and left ventricular ejection fraction of 40% or less receiving standart therapy with diuretic and ACE inhibitor. We randomly assigned patients to bisoprolol 1.25 mg (n=28) or control (n=24) groups. The drug progressively increased to a maximum dose of 5 mg per day. Cardiopulmonary exercise testing (CPET) was performed in all patients of the bisoprolol and control groups before and after 3 months from the beginning of the study.
  
  
  RESULTS
  We found a significant increase in exercise duration, maximal O2 uptake (pik VO2), the O2 uptake at the anaerobic threshold (VO2-AT) and O2-pulse (pik VO2/HR), and improved functional capacity (p<0.001). Bisoprolol produced significant reduction in heart rate at rest (p=0.01) and during maximal exercise (p=0.041). In the control group no significant changes were observed.
  
  
  CONCLUSIONS
  The addition of bisoprolol to the standart therapy in patients with mild to moderate heart failure is well tolerated and improves functional capacity.
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thorax and Cardiovascular Surgery Center, Istanbul. saitterzi@ttnet.net.tr
authors.forename: Sait
authors.initials: S
authors.lastname: Terzi
authors.forename: Sennur Unal
authors.initials: SU
authors.lastname: Dayi
authors.forename: Tamer
authors.initials: T
authors.lastname: Akbulut
authors.forename: Omer
authors.initials: O
authors.lastname: Dağ
authors.forename: Hacer
authors.initials: H
authors.lastname: Köse
authors.forename: Omer
authors.initials: O
authors.lastname: Satiroğlu
authors.forename: Nurten
authors.initials: N
authors.lastname: Sayar
authors.forename: Tuba
authors.initials: T
authors.lastname: Bilsel
authors.forename: Sükrü
authors.initials: S
authors.lastname: Aksoy
authors.forename: Kemal
authors.initials: K
authors.lastname: Yeşilçimen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D017298:Bisoprolol / Q000008:administration & dosage / Q000627:therapeutic use*; D004232:Diuretics / Q000008:administration & dosage; D004334:Drug Administration Schedule; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D012720:Severity of Illness Index
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D017298:Bisoprolol