Document Detail


Lung function with carvedilol and bisoprolol in chronic heart failure: is beta selectivity relevant?
MedLine Citation:
PMID:  17561440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Piergiuseppe Agostoni; Mauro Contini; Gaia Cattadori; Anna Apostolo; Susanna Sciomer; Maurizio Bussotti; Pietro Palermo; Cesare Fiorentini
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2007-06-11
Journal Detail:
Title:  European journal of heart failure     Volume:  9     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-13     Completed Date:  2007-11-27     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  827-33     Citation Subset:  IM    
Affiliation:
Centro Cardiologico Monzino, IRCCS, Istituto di Cardiologia, Università di Milano, Milan, Italy. piergiuseppe.agostoni@ccfm.it
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / 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:
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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