PMID- 16913827
OWN - NLM
STAT- MEDLINE
DCOM- 20061207
LR  - 20181201
IS  - 1175-3277 (Print)
IS  - 1175-3277 (Linking)
VI  - 6
IP  - 4
DP  - 2006
TI  - Effects of nebivolol versus carvedilol on left ventricular function in patients 
      with chronic heart failure and reduced left ventricular systolic function.
PG  - 259-63
AB  - BACKGROUND: Beta-adrenoceptor antagonist (beta-blocker) therapy results in a 
      significant improvement in left ventricular (LV) systolic function and prognosis 
      in patients with chronic heart failure. Both carvedilol and nebivolol produce 
      hemodynamic and clinical benefits in chronic heart failure, but it is unknown 
      whether their peculiar pharmacologic properties produce different effects on LV 
      function. OBJECTIVE: To assess the effects on LV function of nebivolol compared 
      with carvedilol in patients with chronic heart failure and reduced LV systolic 
      function. METHODS: Seventy patients with a LV ejection fraction <or=40% and in 
      New York Heart Association (NYHA) functional class II or III were randomly 
      assigned to receive carvedilol or nebivolol therapy for 6 months. At baseline and 
      after 6 months of treatment, all patients were assessed clinically and by 
      biochemical and hematological investigation, ECG, 24-hour Holter monitoring, 
      echocardiogram, measurement of ventilatory function, and a 6-minute walk test. 
      RESULTS: Compared with baseline values LV end-systolic volume decreased and LV 
      ejection fraction increased in both the carvedilol (from 79 +/- 38mL to 73 +/- 
      43mL and from 33% +/- 6% to 37% +/- 11%) and the nebivolol group (from 72 +/- 
      35mL to 66 +/- 32mL and from 34% +/- 7% to 38% +/- 10%), although the 
      between-group differences were not statistically significant. ECG data showed a 
      decrease in resting HR in both groups (from 83 +/- 20 bpm to 66 +/- 11 bpm for 
      carvedilol and from 81 +/- 15 bpm to 65 +/- 11 bpm for nebivolol; p < 0.001 vs 
      baseline for both groups) but no difference in the PQ, QRS, and QT intervals. 
      Hematologic (in particular, N-terminal pro-brain natriuretic peptide), Holter 
      monitoring (with the exception of HR), and respiratory functional data did not 
      show any significant variation in either group after 6 months' therapy. SBP and 
      DBP decreased in both groups. A small reduction in mean NYHA functional class 
      from baseline was seen in both groups (from 2.5 +/- 0.5 to 2.2 +/- 0.5 for 
      carvedilol [p < 0.05] and from 2.3 +/- 0.4 to 2.2 +/- 0.5 for nebivolol [not 
      significant]). The 6-minute walk test showed a trend toward an increase in the 
      walking distance in both groups. During 6 months of treatment no significant 
      differences in adverse events were observed between the groups. CONCLUSION: 
      Nebivolol is as effective as carvedilol in patients with symptomatic chronic 
      heart failure and reduced LV systolic function.
FAU - Lombardo, Renzo M R
AU  - Lombardo RM
AD  - Department of Cardiology, Ospedale S. Antonio Abate, Trapani, Italy. 
      renzolombardo@libero.it
FAU - Reina, Caterina
AU  - Reina C
FAU - Abrignani, Maurizio G
AU  - Abrignani MG
FAU - Rizzo, Patrizia A
AU  - Rizzo PA
FAU - Braschi, Annabella
AU  - Braschi A
FAU - De Castro, Stefano
AU  - De Castro S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - New Zealand
TA  - Am J Cardiovasc Drugs
JT  - American journal of cardiovascular drugs : drugs, devices, and other 
      interventions
JID - 100967755
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Benzopyrans)
RN  - 0 (Carbazoles)
RN  - 0 (Ethanolamines)
RN  - 0 (Propanolamines)
RN  - 030Y90569U (Nebivolol)
RN  - 0K47UL67F2 (Carvedilol)
SB  - IM
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Adult
MH  - Aged
MH  - Benzopyrans/pharmacology/*therapeutic use
MH  - Carbazoles/pharmacology/*therapeutic use
MH  - Carvedilol
MH  - Electrocardiography/drug effects
MH  - Ethanolamines/pharmacology/*therapeutic use
MH  - Female
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Heart Rate/drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nebivolol
MH  - Propanolamines/pharmacology/*therapeutic use
MH  - Systole/*drug effects
MH  - Ventricular Function, Left/*drug effects
EDAT- 2006/08/18 09:00
MHDA- 2006/12/09 09:00
CRDT- 2006/08/18 09:00
PHST- 2006/08/18 09:00 [pubmed]
PHST- 2006/12/09 09:00 [medline]
PHST- 2006/08/18 09:00 [entrez]
AID - 646 [pii]
AID - 10.2165/00129784-200606040-00006 [doi]
PST - ppublish
SO  - Am J Cardiovasc Drugs. 2006;6(4):259-63. doi: 10.2165/00129784-200606040-00006.