Effects of bisoprolol in patients with stable congestive heart failure.
OBJECTIVE
To analyze the effect of bisoprolol in patients with stable congestive heart failure and who tolerated beta-blockers.


METHODS
Two hundred and one patients performed before and 3 months after maximal tolerated doses of bisoprolol have been reached, a clinical evaluation, an echocardiography, a radionuclide angiography, a cardiopulmonary exercise test and hormonal determinations.


RESULTS
Mean dose of bisoprolol was 8.8 +/- 2.4 mg/d. Patients had a significant improvement in NYHA classification. Heart rate at rest decreased from 87 +/- 17 to 66 +/- 12 beats/min (P < 0.0001) without any effect on electrocardiographic parameters. Left ventricular ejection fraction improved from 31 +/- 11 to 41 +/- 13% (P < 0.0001), with a significant decrease in end-diastolic and end-systolic left ventricle diameters and volumes. Mitral profile improved. Peak VO2 increased from 16.1 +/- 5 to 16.8 +/- 5.5 ml/min/kg (P = 0.001) with a significant increase in O2 pulse (from 8.52 +/- 2.7 to 11.2 +/- 3.5 ml/min/beats, P < 0.0001). Plasma levels of A-type and of B-type natriuretic peptides and of norepinephrine significantly decreased after bisoprolol.


CONCLUSIONS
Bisoprolol significantly improved left ventricle ejection fraction with a reverse remodeling of the left ventricle, a decrease in hormonal activation and a modest improvement in exercise capacity.
de Groote
P
P
Service de cardiologie C, hôpital cardiologique, CHRU de Lille, boulevard du Professeur-J.-Leclercq, 59037 Lille cedex, France. pdegroote@chru-lille.fr
Delour
P
P
Lamblin
N
N
Dagorn
J
J
Verkindère
C
C
Tison
E
E
Millaire
A
A
Bauters
C
C
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D017298:Bisoprolol / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
D000319:Adrenergic beta-Antagonists; D017298:Bisoprolol