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NEbivolol vs. MEtoprolol: comparative randomized Study In patientS with Chronic Heart Failure (NEMESIS-CHF)

Mareev V. Yu., Danielyan M. O., Osmolovskaya Yu. F., Ageev F. T., Seredenina E. M., Zhubrina E. S., Lopatin Yu. M., Platonova Yu. V., Ivanenko V. V., Privalova E. V., Zheleznykh E. A.

Keywords: treatment, metoprolol, nebivolol, CHF

DOI: 10.18087/rhfj.2013.2.1815

Background. The β-adrenoblocker (β-AB) therapy is an essential part of therapy for HF. The choice of β-AB is based on results of clinical studies and includes the drugs which have been proven prognostically beneficial for patients with CHF. Aim. Comparing efficacy and safety of nebovilol and metoprolol tartrate therapy in patients with CHF. Materials and methods. The study included 107 patients with II–III NYHA FC CHF. 58 (54.2 %) of these patients received nebivolol and 49 (45.8 %) patients received metoprolol tartrate. The treatment duration was 24 weeks. During the treatment period, patients received a standard therapy for CHF. Patients were evaluated for changes in their clinical condition by CCS, CHF FC, control of heart rate and BP, ECG, echoCG, arterial wall stiffness, central pressure, 6min walk test, plasma level of brain natriuretic peptide (BNP), blood biochemistry, insulin resistance (IR) degree using HOMA-IR, and biochemical markers of collagen metabolism. Results. Nebivolol was not inferior to metoprolol by the heart rate and BP control in patients with CHF and reduced LV EF. Nebivolol improved the systolic and diastolic heart function to the same degree as metoprolol and was superior to metoprolol in reducing myocardial hypertrophy and left ventricle unloading. Additional vasodilatory effects of nebovilol, as distinct from classic β-AB, allow reducing the intra-aortic resistance to heart ejection in patients with CHF. Nebovilol has an advantage over metoprolol in controlling glucose metabolism, reducing IR, and controlling collagen metabolism. The additional (to selective β-blockade) properties of nebivolol determine its higher clinical efficacy (time course of CHF FC, CSS score, and 6min walk distance) compared to the traditional β-AB metoprolol.
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Mareev V. Yu., Danielyan M. O., Osmolovskaya Yu. F. et al. NEbivolol vs. MEtoprolol: comparative randomized Study In patientS with Chronic Heart Failure (NEMESIS-CHF). Russian Heart Failure Journal. 2013;14 (2):63-74

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