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Bisoprolol in patients with heart failure and moderate to severe chronic obstructive pulmonary disease: a randomized controlled trial
Author(s) -
Hawkins Nathaniel M.,
MacDonald Michael R.,
Petrie Mark C.,
Chalmers George W.,
Carter Roger,
Dunn Francis G.,
McMurray John J.V.
Publication year - 2009
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfp066
Subject(s) - bisoprolol , medicine , copd , heart failure , placebo , chronic bronchitis , cardiology , randomized controlled trial , comorbidity , anesthesia , alternative medicine , pathology
Aims Heart failure (HF) and chronic obstructive pulmonary disease (COPD) frequently coexist. No study has prospectively examined the effects of beta‐blockade in those with both conditions. Methods and results We randomized 27 patients with HF and coexistent moderate or severe COPD to receive bisoprolol or placebo, titrated to maximum tolerated dose over 4 months. The primary outcome was forced expiratory volume in 1 s (FEV 1 ). The study is registered with ClinicalTrials.gov , number: NCT00702156. Patients were elderly and predominantly male. Cardiovascular comorbidity, smoking history, and pulmonary function were similar in each group (mean FEV 1 1.37 vs. 1.26 L, P = 0.52). A reduction in FEV 1 occurred after 4 months following treatment with bisoprolol compared with placebo (−70 vs. +120 mL, P = 0.01). Reversibility following inhaled β 2 ‐agonist and static lung volumes were not impaired by bisoprolol. All measures of health status exhibited a consistent non‐significant improvement, including the Short Form 36 physical and mental component scores (2.6 vs. 0.5 and 0.8 vs. −0.3, respectively), Minnesota Living with Heart Failure Questionnaire (−2.5 vs. 3.5) and Chronic Respiratory Questionnaire (0.07 vs. −0.24). The mean number of COPD exacerbations was similar in the bisoprolol and placebo groups (0.50 and 0.31, respectively, P = 0.44). Conclusion Initiation of bisoprolol in patients with HF and concomitant moderate or severe COPD resulted in a reduction in FEV 1 . However, symptoms and quality of life were not impaired.