Russian Heart Failure Journal 2004year Comparative evaluation of long-term treatment with beta-adrenoblockers in elderly patients with heart failure
Comparative evaluation of long-term treatment with beta-adrenoblockers in elderly patients with heart failure
Logacheva I.V., Pavlenko E.P., Zotov I.L.
Urgency. Despite successful use of β-adrenoblockers (BB) in chronic heart failure (CHF), the question on comparative efficacy of cardioselective BB used in clinical practice (bisoprolol, nebivolol and atenolol) in elderly patients with CHF remains open. Aim. Comparative evaluation of cardioselective BB (bisoprolol, nebivolol and atenolol) in long-term complex management of patients with III–IV functional class (FC) CHF. Material and methods. 128 patients (100 males and 28 females) with III–IV FC CHF of ischemic etiology, aged 65.4±0.4 years were comprehensively evaluated. Patients were randomized to 4 groups: group 1 (control) received a standard therapy for CHF without BB; group 2 received atenolol in addition to the standard therapy; group 3 received additionally nebivolol; and group 4 received additionally bisoprolol. Patients were observed at an outpatient clinic for 6 months. Major hemodynamic indices and parameters of left ventricular (LV) remodeling were evaluated using the ultrasound examination (EchoCG) method. Results. Addition of bisoprolol or nebivolol to the long-term complex therapy in elderly patients with CHF improved the effect of traditional therapy, did not exert a cardiodepressive effect, beneficially influenced parameters of LV geometry, and modulated the «hypertrophic» type of diastolic dysfunction (DD). In the «restrictive» type of DD, administration of BB requires additional investigation.