Hemodynamic and endothelium-protective effects of β-adrenoblockers in patients with coronary heart disease complicated by chronic heart failure and atrial fibrillation

Aim. To elucidate effect of b-adrenoblockers on remodeling of myocardium and adhesive function of endothelium in with ischemic heart disease with chronic heart failure (CHF) and addition of atrial fibrillation (AF). Material and methods. We included into the study 77 patients with functional class II–III CHF and AF of ischemic genesis randomized in 2 groups, In group 1 were included 40 patients who during 24 weeks used carvedilol at the background of basic therapy, in group 2–37 patients receiving metoprolol tartrate. In the work we used clinico-instrumental (echocardiography, test with 60 minute walk), immunoenzymatic (soluble intercellular adhesion molecules (sVCAM, SE – selectin) methods of investigation. Results. Application of both BAB improved clinical state and physical working capacity of patients with CHF and AF. Carvedilol more significantly than metoprolol tartrate prevented remodeling of myocardium, inhibited expression of cellular adhesion molecules. Levels of sE-selectin and VCAM-1 decreased under action of carvedilol. Conclusion. Carvedilol in long term therapy of CHF with AF exerts substantial influence on adhesive function of endothelium and improves hemodynamics.