title: Protective effects of bisoprolol against myocardial injury and pulmonary dysfunction in patients with chronic heart failure.
abstract: OBJECTIVE
  This study was designed to elucidate differences in effects of 2 beta blockers, bisoprolol and carvedilol, in patients with chronic heart failure.
  
  
  BACKGROUND
  Although the beta blockers bisoprolol and carvedilol are commonly used in patients with chronic heart failure, differences in the efficacy and safety of these medications have not been established in this patient population.
  
  
  METHODS
  Patients with chronic systolic heart failure, defined as ≤45% ejection fraction, who had received intensive medical therapy with the exception of beta blockers, were randomly assigned to receive either bisoprolol or carvedilol for 24weeks.
  
  
  RESULTS
  A total of 67 patients were enrolled in the study (bisoprolol: 38 patients, carvedilol: 29 patients). No difference was observed in the improvement of NYHA class, ejection fraction, or N-terminal pro-brain-type natriuretic peptide level between groups. In contrast, the level of high sensitivity troponin T decreased in the bisoprolol group [-4.1±0.9 to -4.5±0.8 log (ng/ml), P=0.003], but did not change in the carvedilol group [-4.4±1.1 to -4.6±0.8 log (ng/ml), P=0.161]. Forced expiratory volume in the first second increased in the bisoprolol group [2.26±0.70 to 2.40±0.70 (L), P=0.014], but did not change in the carvedilol group [2.53±0.71 to 2.59±0.78 (L), P=0.127].
  
  
  CONCLUSIONS
  Bisoprolol might be superior to carvedilol in providing protection from myocardial injury and preserving pulmonary function in patients with chronic systolic heart failure.
authors: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan. Electronic address: s-toyoda@dokkyomed.ac.jp.
authors: Shigeru
authors: S
authors: Toyoda
authors: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan.
authors: Akiko
authors: A
authors: Haruyama
authors: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan.
authors: Shu
authors: S
authors: Inami
authors: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan.
authors: Hirohisa
authors: H
authors: Amano
authors: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan.
authors: Takuo
authors: T
authors: Arikawa
authors: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan.
authors: Masashi
authors: M
authors: Sakuma
authors: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan.
authors: Shichiro
authors: S
authors: Abe
authors: Department of Cardiovascular Medicine, Saga University, Saga, Japan.
authors: Atsushi
authors: A
authors: Tanaka
authors: Department of Cardiovascular Medicine, Saga University, Saga, Japan.
authors: Koichi
authors: K
authors: Node
authors: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan.
authors: Teruo
authors: T
authors: Inoue
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage*; D000368:Aged; D017298:Bisoprolol / Q000008:administration & dosage*; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000187:drug effects* / Q000502:physiology; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests / Q000379:methods; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D002316:Cardiotonic Agents; D020107:Troponin T; D017298:Bisoprolol
keywords: Bisoprolol; Carvedilol; Chronic heart failure; Forced expiratory volume in the first second; High sensitivity troponin T