University of Medicine and Pharmacy Carol Davila, and University and Emergency Hospital of Bucharest, Bucharest, Romania.
J Hypertens. 2011 Apr;29(4):809-17. doi: 10.1097/HJH.0b013e3283442f37.
To assess the effects of antihypertensive treatment on subclinical left ventricular dysfunction and to compare the effects of nebivolol with metoprolol.
This is a prospective, randomized, parallel, active-controlled, PROBE design study (ClinicalTrials.org: NCT00942487) in 60 patients (53±9 years, 67% men) with arterial hypertension, left ventricular hypertrophy, normal ejection fraction, and no coronary heart disease, randomized to either a nebivolol-based or a metoprolol-based treatment, who had conventional and tissue Doppler echocardiography, at rest and during dobutamine stress, at baseline and after 6 months.
SBP and DBP, and resting heart rate decreased by 13, 13, and 12%, respectively, on nebivolol, and by 11, 13, and 7%, respectively, on metoprolol (all, P<0.01). Mean longitudinal early diastolic velocity increased by 16% (P<0.05) on nebivolol compared with 9% (P=not significant) on metoprolol (P=not significant for intergroup differences), whereas flow propagation velocity increased by 34% on nebivolol (P<0.05) and did not change on metoprolol (P<0.01 for intergroup differences). Mean longitudinal displacement increased by 10% on nebivolol (P<0.05) and did not change on metoprolol (P<0.05 for intergroup differences), whereas ejection time increased by 5% on nebivolol (P<0.05) and did not change on metoprolol. All the other parameters of left ventricular function were not different between the two treatment arms.
Patients with mild-to-moderate hypertension have a beneficial effect from 6-month antihypertensive treatment on diastolic longitudinal left ventricular function; effects are significant with nebivolol, but not with metoprolol.
评估抗高血压治疗对亚临床左心室功能障碍的影响，并比较比索洛尔与美托洛尔的疗效。
这是一项前瞻性、随机、平行、主动对照、PROBE 设计研究（ClinicalTrials.org：NCT00942487），纳入 60 例（53±9 岁，67%为男性）高血压、左心室肥厚、射血分数正常且无冠心病的患者，随机分为比索洛尔组或美托洛尔组，两组患者均接受常规和组织多普勒超声心动图检查，包括静息和多巴酚丁胺负荷状态下的检查，分别于基线和 6 个月时进行。
比索洛尔组收缩压和舒张压分别降低 13%和 13%，静息心率降低 12%，美托洛尔组分别降低 11%、13%和 7%（均 P<0.01）。与美托洛尔组（9%，P=无显著差异）相比，比索洛尔组的平均纵向舒张早期速度增加 16%（P<0.05）（P=无组间差异），而血流传播速度增加 34%（P<0.05），美托洛尔组无变化（P<0.01 为组间差异）。比索洛尔组的平均纵向位移增加 10%（P<0.05），美托洛尔组无变化（P<0.05 为组间差异），而比索洛尔组的射血时间增加 5%（P<0.05），美托洛尔组无变化。左心室功能的所有其他参数在两组治疗之间无差异。
轻中度高血压患者接受 6 个月降压治疗对舒张期纵向左心室功能有有益影响；比索洛尔的疗效显著，而美托洛尔则无。
