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Beneficial effects of beta‐blockers on left ventricular function and cellular energy reserve in patients with heart failure
Author(s) -
Spoladore Roberto,
Fragasso Gabriele,
Perseghin Gianluca,
De Cobelli Francesco,
Esposito Antonio,
Maranta Francesco,
Calori Giliola,
Locatelli Massimo,
Lattuada Guido,
Scifo Paola,
Del Maschio Alessandro,
Margonato Alberto
Publication year - 2013
Publication title -
fundamental and clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.655
H-Index - 73
eISSN - 1472-8206
pISSN - 0767-3981
DOI - 10.1111/j.1472-8206.2012.01029.x
Subject(s) - heart failure , phosphocreatine , bisoprolol , medicine , carvedilol , cardiology , ejection fraction , cardiac function curve , heart rate , blood pressure , energy metabolism
Beta‐blockers have been shown to improve left ventricular (LV) function in patients with heart failure. The aim of this study is to non‐invasively assess, by means of in vivo 31P‐magnetic resonance spectroscopy (31P‐MRS), the effects of beta‐blockers on LV cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart failure. Ten heart failure patients on full medical therapy were beta‐blocked by either carvedilol or bisoprolol. Before and after 3 months of treatment, exercise testing, 2D echocardiography, MRS, New York Heart Association (NYHA) class, ejection fraction (EF), maximal rate–pressure product and exercise metabolic equivalent system (METS) were evaluated. Relative concentrations of PCr and ATP were determined by cardiac 31P‐MRS. After beta‐blockade, NYHA class decreased (from 2.2 ± 0.54 to 1.9 ± 0.52, P = 0.05), whereas EF (from 33 ± 7 to 44 ± 6%, P = 0.0009) and METS (from 6.74 ± 2.12 to 8.03 ± 2.39, P = 0.01) increased. Accordingly, the mean cardiac PCr/ATP ratio increased by 33% (from 1.48 ± 0.22 to 1.81 ± 0.48, P = 0.03). Beta‐blockade‐induced symptomatic and functional improvement in patients with heart failure is associated to increased PCr/ATP ratio, indicating preservation of myocardial high‐energy phosphate levels.