title: Reversal of subclinical left ventricular dysfunction by antihypertensive treatment: a prospective trial of nebivolol against metoprolol.
abstract: OBJECTIVE
  To assess the effects of antihypertensive treatment on subclinical left ventricular dysfunction and to compare the effects of nebivolol with metoprolol.
  
  
  METHODS
  This is a prospective, randomized, parallel, active-controlled, PROBE design study (ClinicalTrials.org: NCT00942487) in 60 patients (53±9 years, 67% men) with arterial hypertension, left ventricular hypertrophy, normal ejection fraction, and no coronary heart disease, randomized to either a nebivolol-based or a metoprolol-based treatment, who had conventional and tissue Doppler echocardiography, at rest and during dobutamine stress, at baseline and after 6 months.
  
  
  RESULTS
  SBP and DBP, and resting heart rate decreased by 13, 13, and 12%, respectively, on nebivolol, and by 11, 13, and 7%, respectively, on metoprolol (all, P<0.01). Mean longitudinal early diastolic velocity increased by 16% (P<0.05) on nebivolol compared with 9% (P=not significant) on metoprolol (P=not significant for intergroup differences), whereas flow propagation velocity increased by 34% on nebivolol (P<0.05) and did not change on metoprolol (P<0.01 for intergroup differences). Mean longitudinal displacement increased by 10% on nebivolol (P<0.05) and did not change on metoprolol (P<0.05 for intergroup differences), whereas ejection time increased by 5% on nebivolol (P<0.05) and did not change on metoprolol. All the other parameters of left ventricular function were not different between the two treatment arms.
  
  
  CONCLUSIONS
  Patients with mild-to-moderate hypertension have a beneficial effect from 6-month antihypertensive treatment on diastolic longitudinal left ventricular function; effects are significant with nebivolol, but not with metoprolol.
authors.affiliation: University of Medicine and Pharmacy Carol Davila, and University and Emergency Hospital of Bucharest, Bucharest, Romania. dvinereanu@yahoo.com
authors.forename: Dragos
authors.initials: D
authors.lastname: Vinereanu
authors.forename: Carmen
authors.initials: C
authors.lastname: Gherghinescu
authors.forename: Andrea O
authors.initials: AO
authors.lastname: Ciobanu
authors.forename: Stefania
authors.initials: S
authors.lastname: Magda
authors.forename: Natalia
authors.initials: N
authors.lastname: Niculescu
authors.forename: Raluca
authors.initials: R
authors.lastname: Dulgheru
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Dragoi
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lautaru
authors.forename: Mircea
authors.initials: M
authors.lastname: Cinteza
authors.forename: Alan G
authors.initials: AG
authors.lastname: Fraser
mesh_terms: D000328:Adult; D001578:Benzopyrans / Q000627:therapeutic use*; D004562:Electrocardiography; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D000068577:Nebivolol; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
chemical_list: D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol; D008790:Metoprolol