Selective versus nonselective β-adrenergic receptor blockade in chronic heart failure: differential effects on myocardial energy substrate utilization
| Autor: | John S. Floras, Eduardo R. Azevedo, John D. Parker, Gary D. Lopaschuk, Abdul Al-Hesayen, Shauna Hollingshead |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
medicine.medical_specialty Sympathetic nervous system Sympathetic Nervous System Adolescent Adrenergic beta-Antagonists Carbazoles Hemodynamics Adrenergic Fatty Acids Nonesterified Propanolamines Norepinephrine (medication) Oxygen Consumption Double-Blind Method Internal medicine Humans Medicine Carvedilol Coronary sinus Aged Metoprolol Aged 80 and over Heart Failure business.industry Myocardium Middle Aged medicine.disease medicine.anatomical_structure Heart failure Lactates Cardiology Energy Metabolism Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | European Journal of Heart Failure. 7:618-623 |
| ISSN: | 1388-9842 |
| Popis: | Background: Non-selective and selective β-blockers have been shown to improve outcomes in chronic heart failure (CHF). Recent data suggests the non-selective β-blockers have a more favourable effect on outcomes than β1-selective agents. We sought to examine the differential effects of non-selective versus selective β-blockade on myocardial substrate utilization in patients with CHF. Methods and results: Twenty-two patients with CHF were randomised to the non-selective β-blocker carvedilol or the selective β-blocker metoprolol (double-blind). Measurement of hemodynamics, arterial and coronary sinus free fatty acid (FFA) and lactate levels, and cardiac norepinephrine spillover (CANESP) were made before and after 4 months of therapy. In the carvedilol group (n=11), there was a significant reduction in myocardial FFA uptake (0.12±0.02 to 0.1±0.02 mmol/l, P |
| Databáze: | OpenAIRE |
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