Effects of beta-blocker therapy on high sensitivity c-reactive protein, oxidative stress, and cardiac function in patients with congestive heart failure.
BACKGROUND
It is uncertain whether beta-blocker therapy affects serum C-reactive protein (CRP) level in patients with congestive heart failure (CHF). We attempted to determine if beta-blocker therapy decreases serum CRP production and to correlate the production with biomarkers and cardiac function in such patients.


RESULTS
Fifty-two patients with mild to moderate CHF with a left ventricular ejection fraction (EF) <40% were enrolled. They were randomly assigned to metoprolol or carvedilol treatment groups. The CRP concentration decreased significantly in patients with higher baseline CRP concentration, but not in those with lower baseline CRP concentrations. There was an inverse correlation between DeltaCRP and DeltaEF 16 weeks after the start of beta-blocker therapy for patients with higher baseline CRP concentrations. In patients with higher baseline concentrations, CRP decreased in patients who received carvedilol, but not in those who received metoprolol. Plasma lipid peroxide (LPO) concentration significantly decreased, and there was an inverse correlation between DeltaCRP and DeltaLPO 16 weeks after the start of therapy.


CONCLUSIONS
Administration of beta-blockers is associated with attenuation of inflammatory marker in certain patients with CHF. The antioxidant effects of beta-blockers, especially carvedilol, may play a role in mediating the phenomenon.
Nagatomo
Yuji
Y
Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Yoshikawa
Tsutomu
T
Kohno
Takashi
T
Yoshizawa
Akihiro
A
Anzai
Toshihisa
T
Meguro
Tomomi
T
Satoh
Toru
T
Ogawa
Satoshi
S
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002227:Carbazoles / Q000494:pharmacology* / Q000627:therapeutic use; D000077261:Carvedilol; D017079:Exercise Tolerance / Q000187:drug effects; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D015227:Lipid Peroxidation; D008297:Male; D008790:Metoprolol / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D018384:Oxidative Stress / Q000187:drug effects*; D010101:Oxygen Consumption / Q000187:drug effects; D011412:Propanolamines / Q000494:pharmacology* / Q000627:therapeutic use; D015635:Radionuclide Ventriculography; D016037:Single-Blind Method
D000319:Adrenergic beta-Antagonists; D015415:Biomarkers; D002227:Carbazoles; D015850:Interleukin-6; D011412:Propanolamines; D000077261:Carvedilol; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D008790:Metoprolol