Nebivolol Improves Coronary Flow Reserve in Patients with Idiopathic Dilated Cardiomyopathy

Dogan Erdogan ^1*, Hakan Gullu ¹, Mustafa Caliskan ¹, Ozgur Ciftci ¹, Semra Topcu ¹, Aylin Yildirir ¹ and Haldun Muderrisoglu ¹

¹ Baskent University, Konya Teaching and Medical Research Center, Turkey

^* To whom correspondence should be addressed. E-mail: aydoganer{at}hotmail.com.

Accepted 3 July 2006

Abstract

Background Impaired coronary flow reserve (CFR) is a significant predictor of poor prognosis in patients with idiopathic dilated cardiomyopathy (IDC). Nebivolol reduces mortality and morbidity in patients with heart failure and left ventricular dysfunction, including cases caused by IDC. Therefore, the purpose of the present study was to assess the effects of nebivolol on CFR in patients with IDC.

Methods In this study, CFR was measured in 21 clinically stable patients with IDC (ejection fraction 35.7±6.2) at baseline and after 1 month of treatment with nebivolol once daily. A control group of apparently healthy subjects who were matched for age and sex was used for comparison. Resting and hyperemic coronary flows were measured using transthoracic second harmonic Doppler echocardiography. None of the subjects had any systemic disease.

Results After 1 month of therapy, heart rate was reduced significantly (P <0.001). The blood pressure was decreased significantly (P <0.001). Left ventricular (LV) end-diastolic diameter and stroke volume were not changed significantly, but end-systolic diameter was decreased significantly (P <0.05). Resting rate-pressure product was lower after nebivolol, but dipyridamole-induced change was not influenced by the therapy. Nebivolol therapy reduced significantly coronary velocities at rest (P <0.02), and also caused a significantly increase in coronary velocities after dipyridamole (P <0.02), leading to a greater CFR (2.02±0.35 vs. 2.61±0.43, P <0.001). Nebivolol induced an absolute increase of 6% in the CFR in 17 of 21 patients (80.9%).

Conclusions In patients with IDC 1-month nebivolol therapy induces a significant increase in CFR.

Keywords: Coronary flow reserve, Doppler echocardiography, dilated cardiomyopathy, nebivolol

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