title: Carvedilol and nebivolol improve left ventricular systolic functions in patients with non-ischemic heart failure.
abstract: OBJECTIVE
  It is unclear whether carvedilol and nebivolol produce different effects on short-term left ventricle (LV) systolic function in heart failure (HF). These drugs could improve systolic and diastolic functions of the LV. Thus, we aimed to compare their effects on LV systolic functions in patients with non-ischemic HF.
  
  
  METHODS
  This study included 61 symptomatic non-ischemic HF patients with low ejection fraction (EF) (EF≤40%) between September 2008 and November 2010. The patients were randomized to carvedilol (n=31, 16 males) or nebivolol (n=30, 19 male). They were evaluated clinically and echocardiographically at baseline and 3 and 6 months after target dose; 42% of patients in the carvedilol group and 47% in the nebivolol group achieved the target dose before randomization. LV systolic functions were evaluated with ventricle diameters, EF, ejection time (ET), isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), and myocardial performance index (MPI).
  
  
  RESULTS
  At 6 months, carvedilol and nebivolol similarly improved EF (from 33±4% to 36±5%, p<0.01 and from 34±5% to 37±5%, p<0.01, inter-group p=0.30, respectively) and MPI (from 0.71±0.10 to 0.53±0.07, p<0.01 and from 0.69±0.13 to 0.52±0.08, p<0.01, intergroup p=0.45, respectively). LV diameter was reduced by a similar extent in both groups. In each group, IVCT and IVRT were significantly shortened and ET was prolonged, but there was no inter-group difference. Functional capacity improved similarly (from NYHA Class II-III to Class I-0) in both groups, as did heart rate and blood pressure. Reduction of pro-B-type natriuretic peptide levels was also comparable in both groups (p=0.41).
  
  
  CONCLUSIONS
  Carvedilol and nebivolol can similarly improve LV systolic functions in non-ischemic HF patients.
authors.affiliation: Clinic of Cardiology, Isparta State Hospital; Isparta-Turkey. tayyar81@hotmail.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karabacak
authors.forename: Abdullah
authors.initials: A
authors.lastname: Doğan
authors.forename: Şenol
authors.initials: Ş
authors.lastname: Tayyar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Özaydın
authors.forename: Doğan
authors.initials: D
authors.lastname: Erdoğan
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000494:pharmacology / Q000627:therapeutic use*; D000077261:Carvedilol; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol / Q000494:pharmacology / Q000627:therapeutic use*; D011412:Propanolamines / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000068577:Nebivolol; D000077261:Carvedilol