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Beneficial effects of beta-blockers on left ventricular function and cellular energy reserve in patients with heart failure.
MedLine Citation:
PMID:  22320703     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Beta-blockers have been shown to improve left ventricular (LV) function in patients with heart failure. The aim of this study is to non-invasively assess, by means of in vivo 31P-magnetic resonance spectroscopy (31P-MRS), the effects of beta-blockers on LV cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart failure. Ten heart failure patients on full medical therapy were beta-blocked by either carvedilol or bisoprolol. Before and after 3 months of treatment, exercise testing, 2D echocardiography, MRS, New York Heart Association (NYHA) class, ejection fraction (EF), maximal rate-pressure product and exercise metabolic equivalent system (METS) were evaluated. Relative concentrations of PCr and ATP were determined by cardiac 31P-MRS. After beta-blockade, NYHA class decreased (from 2.2 ± 0.54 to 1.9 ± 0.52, P = 0.05), whereas EF (from 33 ± 7 to 44 ± 6%, P = 0.0009) and METS (from 6.74 ± 2.12 to 8.03 ± 2.39, P = 0.01) increased. Accordingly, the mean cardiac PCr/ATP ratio increased by 33% (from 1.48 ± 0.22 to 1.81 ± 0.48, P = 0.03). Beta-blockade-induced symptomatic and functional improvement in patients with heart failure is associated to increased PCr/ATP ratio, indicating preservation of myocardial high-energy phosphate levels.
Authors:
Roberto Spoladore; Gabriele Fragasso; Gianluca Perseghin; Francesco De Cobelli; Antonio Esposito; Francesco Maranta; Giliola Calori; Massimo Locatelli; Guido Lattuada; Paola Scifo; Alessandro Del Maschio; Alberto Margonato
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-9
Journal Detail:
Title:  Fundamental & clinical pharmacology     Volume:  -     ISSN:  1472-8206     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710411     Medline TA:  Fundam Clin Pharmacol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Fundamental and Clinical Pharmacology © 2012 Société Française de Pharmacologie et de Thérapeutique.
Affiliation:
Clinical Cardiology - Heart Failure Clinic, Istituto Scientifico-Università Vita/Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy Internal Medicine - Section of Nutrition/Metabolism, Istituto Scientifico-Università Vita/Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy Department of Radiology, Istituto Scientifico-Università Vita/Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy Department of Clinical Chemistry, Scientific Institute H San Raffaele, Istituto Scientifico-Università Vita/Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy.
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