Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea.
Kang Pil Urology Clinic, Busan, Republic of Korea.
Medicine (Baltimore). 2023 Sep 8;102(36):e35008. doi: 10.1097/MD.0000000000035008.
Benign prostatic hypertrophy (BPH) is associated with autonomic dysfunction and sympathetic nervous system mediated by the alpha receptor. However, limited data exist regarding the effects of the beta-blocker (BB) carvedilol on arrhythmia and urologic outcomes in BPH patients. Our database of patients diagnosed with BPH from 2015 to 2020 was used to obtain echocardiography and electrocardiogram data. Inclusion criteria were BPH patients taking BBs. International Prostate Symptom Score questionnaire were used to evaluate the urinary symptoms and quality of life. Among 448 patients with BPH (69.2 ± 10.9 years) taking BBs, 219 patients took carvedilol (48.9%) and 229 patients took a non-carvedilol BB (51.1%; bisoprolol, 184 patients, 80% or nebivolol, 45 patients, 20%). Difference in the baseline characteristics was not observed. During the median 36-month follow-up, a lower incidence of arrhythmic events (P = .029), total urologic events (P < .001), and less use of additive alpha-blocker was observed in the carvedilol group (P = .022). In multivariate analysis, less carvedilol use (P = .019), heart failure (P < .001), stroke (P < .001), and cardiomyopathy (P = .046) were independent risk factors for arrhythmic events. In addition, less carvedilol use (P = .009) and older age (P = .005) were independent risk factors for urologic events based on BB type at the median 36-month follow-up. The use of carvedilol was associated with less arrhythmic events in BPH patients with palpitation and decreased the incidence of urologic events in BPH compared with the use of non-carvedilol BBs in long-term follow-up.
良性前列腺增生（BPH）与自主神经功能障碍和交感神经系统有关，由α受体介导。然而，关于β受体阻滞剂（BB）卡维地洛对 BPH 患者心律失常和泌尿科结局的影响的数据有限。我们使用 2015 年至 2020 年期间诊断为 BPH 的患者数据库获得超声心动图和心电图数据。纳入标准为服用 BB 的 BPH 患者。采用国际前列腺症状评分问卷评估患者的泌尿系统症状和生活质量。在服用 BB 的 448 例 BPH 患者（69.2±10.9 岁）中，219 例服用卡维地洛（48.9%），229 例服用非卡维地洛 BB（51.1%；比索洛尔 184 例，80%，或 nebivolol 45 例，20%）。两组患者的基线特征无差异。在中位 36 个月的随访期间，卡维地洛组心律失常事件（P=0.029）、总泌尿科事件（P<0.001）和附加α受体阻滞剂使用率较低（P=0.022）。多变量分析显示，卡维地洛使用率较低（P=0.019）、心力衰竭（P<0.001）、中风（P<0.001）和心肌病（P=0.046）是心律失常事件的独立危险因素。此外，在中位 36 个月的随访中，卡维地洛使用率较低（P=0.009）和年龄较大（P=0.005）是基于 BB 类型的泌尿科事件的独立危险因素。在长期随访中，与使用非卡维地洛 BB 相比，卡维地洛的使用与 BPH 患者心悸时的心律失常事件减少有关，并降低了 BPH 患者泌尿科事件的发生率。
