| Nebivolol therapy improves endothelial function and increases exercise tolerance in patients with cardiac syndrome X. | |
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MedLine Citation:
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PMID: 19819787 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We sought to determine whether nebivolol affects coronary endothelial function and exercise induced ischemia in patients with cardiac syndrome X (CSX). METHODS: The study protocol undertaken was based on a single-blind randomized controlled prospective study. After a 2-week washout period, 38 patients with cardiac syndrome X were randomized to receive either nebivolol 5 mg daily (n=19) or metoprolol 50 mg daily (n=19) in a single- blind design for 12 weeks. The control group under study was consisted of 16 age- and gender-matched subjects with negative treadmill exercise tests. Plasma endothelial nitric oxide (NOx), L-arginine, and asymmetric dimethylarginine (ADMA) were measured in all patients at baseline and after 12 weeks of treatment. Statistical differences among groups were tested by one-way analysis of variance and unpaired samples t test for parametric; Kruskal-Wallis and Mann-Whitney U tests for non-parametric variables, respectively. A paired samples t test was used to compare continuous variables before and after drug therapy. RESULTS: At baseline, plasma level of NOx, L-arginine, and L-arginine/ADMA ratio were lower (p<0.001 for all) in patients with CSX than in the control patients. Whereas, the plasma ADMA levels were increased in the patient group (p<0.001). After 12 weeks of drug therapy, the patients taking nebivolol had increased levels of plasma NOx , plasma L-arginine, the L-arginine/ADMA ratio and decreased levels of plasma ADMA compared to those of the patients taking metoprolol (p<0.001). In addition, exercise duration to 1-mm ST depression and total exercise duration significantly increased after treatment in the nebivolol group compared to the metoprolol group (p<0.01). In the nebivolol group, Canadian Cardiovascular Society (CCS) angina classification improved by one or more categories in 12 (70%) patients, whereas it deteriorated or remained in the same category in 5 (30%) patients. Meanwhile, in the metoprolol group, the CCS angina classification improved by one or more categories in 7 (41%), whereas it deteriorated or remained in the same category in 10 (59%) patients. CONCLUSION: Circulating endothelial function parameters (plasma ADMA, L-arginine, NOx levels) were impaired in patients with CSX. Nebivolol treatment was associated with better improvements in both circulating endothelial function and exercise stress test parameters than metoprolol. We believe that further studies are needed to evaluate the effects of nebivolol treatment on long-term clinical outcomes in patients with CSX. |
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Authors:
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Nihat Sen; Yusuf Tavil; H?samettin Erdamar; H?seyin U?ur Yazici; Erdin? Cakir; Emin Ozg?r Akg?l; Cumhur Bilgi; Mehmet Kemal Erbil; Fatih Poyraz; Kaan Okyay; Murat Turfan; Mustafa Cemri |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology Volume: 9 ISSN: 1308-0032 ISO Abbreviation: Anadolu Kardiyol Derg Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-12 Completed Date: 2010-02-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101095069 Medline TA: Anadolu Kardiyol Derg Country: Turkey |
Other Details:
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Languages: eng Pagination: 371-9 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey. nihatdrsen@yahoo.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use* Arginine / analogs & derivatives, blood Benzopyrans / therapeutic use* Blood Pressure / drug effects Endothelium, Vascular / drug effects, physiology, physiopathology Ethanolamines / therapeutic use* Exercise Test Heart Catheterization Heart Rate / drug effects Humans Metoprolol / therapeutic use Microvascular Angina / drug therapy* Nitric Oxide / blood Single-Blind Method |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Benzopyrans; 0/Ethanolamines; 0/dimethylarginine; 10102-43-9/Nitric Oxide; 37350-58-6/Metoprolol; 74-79-3/Arginine; 99200-09-6/nebivolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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