Effects of nebivolol on biomarkers in elderly patients with heart failure
Language English Country Netherlands Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
PubMed
24877590
DOI
10.1016/j.ijcard.2014.05.018
PII: S0167-5273(14)01001-8
Knihovny.cz E-resources
- Keywords
- Beta blockers in heart failure, NT-Pro BNP and beta blockers, Nebivolol, Neurohormones, SENIORS substudy,
- MeSH
- Adrenergic beta-1 Receptor Antagonists therapeutic use MeSH
- Benzopyrans therapeutic use MeSH
- Biomarkers blood MeSH
- Cytokines blood MeSH
- Double-Blind Method MeSH
- Ethanolamines therapeutic use MeSH
- Internationality * MeSH
- Humans MeSH
- Nebivolol MeSH
- Neurotransmitter Agents blood MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Heart Failure blood drug therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Names of Substances
- Adrenergic beta-1 Receptor Antagonists MeSH
- Benzopyrans MeSH
- Biomarkers MeSH
- Cytokines MeSH
- Ethanolamines MeSH
- Nebivolol MeSH
- Neurotransmitter Agents MeSH
BACKGROUND: Heart failure activates neurohormones, and elevated levels of brain natriuretic peptide (BNP) are associated with adverse outcomes. The SENIORS trial showed that nebivolol, a highly selective beta-1 antagonist with vasodilating properties, reduced the composite outcome of all cause mortality or cardiovascular hospital admissions in older patients with heart failure. We explored the effects of nebivolol on a range of neurohormones, cytokines and markers of nitric oxide activity in heart failure. METHODS: In a subset of patients in SENIORS we measured N-terminal pro-brain natriuretic peptide (NT-BNP), pro atrial natriuretic peptide (Pro-ANP), endothelin-1 (ET-1), peripheral norepinephrine (PNE), soluble Fas (sFas), soluble Fas-ligand (sFas-L), tumour necrosis factor-alpha (TNF-α), serum uric acid (SUA), symmetrical dimethyl arginine (SDMA), arginine, citrulline and asymmetrical dimethyl arginine (ADMA) at baseline (before study drug), at 6 months and 12 months in a prespecified substudy. RESULTS: One hundred and six patients were enrolled and 75 had a baseline and at least one follow-up sample. There were no significant differences in neurohormone cytokines or nitric oxide markers measured between the two groups at six or twelve months. NT-ProBNP showed a numerical increase in the nebivolol group compared to placebo (P=0.08) and sFas showed a numerical increase in patients on placebo (P=0.08). Mean baseline LVEF was 35% in both groups and at 12 months was 43% on nebivolol group and 34% on placebo group (P=0.01). CONCLUSION: There were trends but no clear changes associated with nebivolol in neurohormones, cytokines or markers of nitric oxide activity in this study of elderly patients with heart failure. Further studies are needed to understand the mechanistic effects of beta blockers on biomarkers in heart failure.
1st Internal Cardioangiological Dept St Anne's Hospital and Medical Faculty Brno Czech Republic
Cardiovascular Markers St George's Hospital University London UK
Cluj Napoca University Hospital Romania
Department of Chemical Pathology St George's Hospital London UK
Monash University Australia; Melbourne University Australia; Warwick University UK
Whipps Cross University Hospital Barts Health NHS Trust London UK
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