| Lung function with carvedilol and bisoprolol in chronic heart failure: is beta selectivity relevant? | |
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MedLine Citation:
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PMID: 17561440 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Carvedilol is a beta-blocker with similar affinity for beta1- and beta2 receptors, while bisoprolol has higher beta1 affinity. The respiratory system is characterized by beta2-receptor prevalence. Airway beta receptors regulate bronchial tone and alveolar beta receptors regulate alveolar fluid re-absorption which influences gas diffusion. AIMS: To compare the effects of carvedilol and bisoprolol on lung function in patients with chronic heart failure (CHF). METHODS AND RESULTS: We performed a double-blind, cross-over study in 53 CHF patients. After 2 months of full dose treatment with either carvedilol or bisoprolol, we assessed lung function by salbutamol challenge, carbon monoxide lung diffusion (DLCO), including membrane conductance (DM), and gas exchange during exercise. FEV1 and FVC were similar; after salbutamol FEV1 was higher with bisoprolol (p<0.04). DLco was 82+/-21% of predicted with carvedilol and 90+/-20% with bisoprolol (p<0.01) due to DM changes. Peak VO2 was 17.8+/-4.5 mL/min/kg on bisoprolol and 17.0+/-4.6 on carvedilol, (p<0.05) with no differences in bronchial tone (same expiratory time) throughout exercise. Differences were greater in the 22 subjects with DLCO<80%. CONCLUSION: Carvedilol and bisoprolol have different effects on DLCO and response to salbutamol. DLCO differences, being DM related, are due to changes in active membrane transport which is under alveolar beta2-receptor control. Peak VO2 was slightly higher with bisoprolol particularly in CHF patients with reduced DLCO. |
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Authors:
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Piergiuseppe Agostoni; Mauro Contini; Gaia Cattadori; Anna Apostolo; Susanna Sciomer; Maurizio Bussotti; Pietro Palermo; Cesare Fiorentini |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2007-06-11 |
Journal Detail:
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Title: European journal of heart failure Volume: 9 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-08-13 Completed Date: 2007-11-27 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 827-33 Citation Subset: IM |
Affiliation:
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Centro Cardiologico Monzino, IRCCS, Istituto di Cardiologia, Università di Milano, Milan, Italy. piergiuseppe.agostoni@ccfm.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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pharmacology*,
therapeutic use Aged Bisoprolol / therapeutic use* Carbazoles / pharmacology*, therapeutic use Chronic Disease Cross-Over Studies Double-Blind Method Exercise / physiology Female Heart Failure / drug therapy*, physiopathology* Hemodynamics Humans Lung / drug effects, physiopathology* Male Middle Aged Oxygen Consumption / drug effects Propanolamines / pharmacology*, therapeutic use Pulmonary Diffusing Capacity / drug effects, physiology Respiratory Function Tests |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Propanolamines; 66722-44-9/Bisoprolol; 72956-09-3/carvedilol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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