Brehm Bernhard R, Wolf Sabine C, Görner Sandra, Buck-Müller Nina, Risler Teut
Medizinische Klinik III, Otfried-Müllerstr 10, 72076 Tübingen, Germany.
Eur J Heart Fail. 2002 Dec;4(6):757-63. doi: 10.1016/s1388-9842(02)00113-7.
Sympathetic activity is a significant predictor of a poor prognosis in heart failure. Beta-blockers have been shown to improve the prognosis of patients with heart failure.
This pilot study examined the tolerability and efficacy of the new beta-blocker nebivolol on left ventricular function in patients with chronic heart failure.
Twelve patients with an ejection fraction of 13-39% were included in this double blind, placebo-controlled randomized trial of nebivolol administered in addition to standard therapy. Exercise time, heart rate, left ventricular function and tolerability were examined at baseline and after 3 months of orally administered nebivolol (2.5 and 5 mg, n = 6) or placebo (n = 6). Nebivolol was well tolerated and the NYHA class improved in four patients. Heart rate decreased while the maximal exercise duration and performance remained stable. Left ventricular function increased (ejection fraction 31.5 +/- 10.11 to 42.0 +/- 10.99%, P < or = 0.01) after 12 weeks of nebivolol. The left ventricular end-systolic diameter decreased in the nebivolol-group from 56.5 +/- 9.40 to 50.2 +/- 9.43 mm (P < or = 0.02).
These data indicate that nebivolol might improve cardiac function in patients with reduced left ventricular function.
交感神经活动是心力衰竭预后不良的重要预测指标。β受体阻滞剂已被证明可改善心力衰竭患者的预后。
本初步研究探讨了新型β受体阻滞剂奈必洛尔对慢性心力衰竭患者左心室功能的耐受性和疗效。
本双盲、安慰剂对照的随机试验纳入了12例射血分数为13%-39%的患者，在标准治疗基础上加用奈必洛尔。在基线时以及口服奈必洛尔（2.5mg和5mg，n = 6）或安慰剂（n = 6）3个月后，检测运动时间、心率、左心室功能和耐受性。奈必洛尔耐受性良好，4例患者纽约心脏协会（NYHA）心功能分级改善。心率下降，而最大运动持续时间和运动能力保持稳定。服用奈必洛尔12周后，左心室功能增强（射血分数从31.5±10.11%增至42.0±10.99%，P≤0.01）。奈必洛尔组左心室收缩末期内径从56.5±9.40mm降至50.2±9.43mm（P≤0.02）。
这些数据表明，奈必洛尔可能改善左心室功能降低患者的心脏功能。
