Protective effects of nebivolol against anthracycline-induced cardiomyopathy: a randomized control study.
BACKGROUND
We aimed to evaluate the effect of prophylactic nebivolol use on prevention of antracycline-induced cardiotoxicity in breast cancer patients.


METHODS
In this small, prospective, double-blind study, we randomly assigned 45 consecutive patients with breast cancer and planned chemotheraphy to receive nebivolol 5mg daily (n=27) or placebo (n=18). Echocardiographic measurements and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels were obtained at baseline and at 6-month of chemotherapy.


RESULTS
Both studied groups had comparable echocardiographic variables and NT-pro-BNP levels at baseline. At 6-month, the left ventricular (LV) end-systolic and end-diastolic diameters increased in the placebo group (LVESD: 29.7 ± 3.4 to 33.4 ± 4.5mm; LVEDD: 47.2 ± 3.8 to 52.0 ± 4.6mm, p=0.01 for both) but remained unchanged in the nebivolol group (LVESD: 30.4 ± 3.5 to 31.0 ± 3.6mm, p=0.20; LVEDD: 47.0 ± 4.4 to 47.1 ± 4.0mm, p=0.93). The placebo group also had lower LVEF than the nebivolol group (57.5 ± 5.6% vs. 63.8 ± 3.9%, p=0.01) at 6-month. NT-pro-BNP level remained static in the nebivolol group (147 ± 57 to 152 ± 69 pmol/l, p=0.77) while it increased in the placebo group (144 ± 66 to 204 ± 73 pmol/l, p=0.01).


CONCLUSIONS
Prophylactic use of nebivolol treatment may protect the myocardium against antracycline-induced cardiotoxicity in breast cancer patients.
Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
Mehmet G
MG
Kaya
Metin
M
Ozkan
Ozgur
O
Gunebakmaz
Hasan
H
Akkaya
Esma G
EG
Kaya
Mahmut
M
Akpek
Nihat
N
Kalay
Mustafa
M
Dikilitas
Mikail
M
Yarlioglues
Halit
H
Karaca
Veli
V
Berk
Idris
I
Ardic
Ali
A
Ergin
Yat Yin
YY
Lam
D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects; D001578:Benzopyrans / Q000008:administration & dosage*; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000517:prevention & control*; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D004983:Ethanolamines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D000068577:Nebivolol; D011446:Prospective Studies; D014463:Ultrasonography
D018943:Anthracyclines; D000970:Antineoplastic Agents; D001578:Benzopyrans; D002316:Cardiotonic Agents; D004983:Ethanolamines; D000068577:Nebivolol