Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction
Abstract Background: More than 50% of the patients with heart failure have normal ejection fraction (HFNEF). Iodine-123 metaiodobenzylguanidine (123I-MIBG) scintigraphy and cardiopulmonary exercise test (CPET) are prognostic markers in HFNEF. Nebivolol is a beta-blocker with vasodilating properties...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cardiologia (SBC)
2016-01-01
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016005010101&lng=en&tlng=en |
| _version_ | 1819114487250157568 |
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| author | Leandro Rocha Messias Aryanne Guimarães Ferreira Sandra Marina Ribeiro de Miranda José Antônio Caldas Teixeira Jader Cunha de Azevedo Ana Carolina Nader Vasconcelos Messias Elisabeth Maróstica Claudio Tinoco Mesquita |
| author_facet | Leandro Rocha Messias Aryanne Guimarães Ferreira Sandra Marina Ribeiro de Miranda José Antônio Caldas Teixeira Jader Cunha de Azevedo Ana Carolina Nader Vasconcelos Messias Elisabeth Maróstica Claudio Tinoco Mesquita |
| author_sort | Leandro Rocha Messias |
| collection | DOAJ |
| description | Abstract Background: More than 50% of the patients with heart failure have normal ejection fraction (HFNEF). Iodine-123 metaiodobenzylguanidine (123I-MIBG) scintigraphy and cardiopulmonary exercise test (CPET) are prognostic markers in HFNEF. Nebivolol is a beta-blocker with vasodilating properties. Objectives: To evaluate the impact of nebivolol therapy on CPET and123I-MIBG scintigraphic parameters in patients with HFNEF. Methods: Twenty-five patients underwent 123I-MIBG scintigraphy to determine the washout rate and early and late heart-to-mediastinum ratios. During the CPET, we analyzed the systolic blood pressure (SBP) response, heart rate (HR) during effort and recovery (HRR), and oxygen uptake (VO2). After the initial evaluation, we divided our cohort into control and intervention groups. We then started nebivolol and repeated the tests after 3 months. Results: After treatment, the intervention group showed improvement in rest SBP (149 mmHg [143.5-171 mmHg] versus 135 mmHg [125-151 mmHg, p = 0.016]), rest HR (78 bpm [65.5-84 bpm] versus 64.5 bpm [57.5-75.5 bpm, p = 0.028]), peak SBP (235 mmHg [216.5-249 mmHg] versus 198 mmHg [191-220.5 mmHg], p = 0.001), peak HR (124.5 bpm [115-142 bpm] versus 115 bpm [103.7-124 bpm], p= 0.043), HRR on the 1st minute (6.5 bpm [4.75-12.75 bpm] versus 14.5 bpm [6.7-22 bpm], p = 0.025) and HRR on the 2nd minute (15.5 bpm [13-21.75 bpm] versus 23.5 bpm [16-31.7 bpm], p = 0.005), but no change in peak VO2 and 123I-MIBG scintigraphic parameters. Conclusion: Despite a better control in SBP, HR during rest and exercise, and improvement in HRR, nebivolol failed to show a positive effect on peak VO2 and 123I-MIBG scintigraphic parameters. The lack of effect on adrenergic activity may be the cause of the lack of effect on functional capacity. |
| first_indexed | 2024-12-22T04:46:05Z |
| format | Article |
| id | doaj.art-c0fc9564dfce4338bbb304db03690195 |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-12-22T04:46:05Z |
| publishDate | 2016-01-01 |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-c0fc9564dfce4338bbb304db036901952022-12-21T18:38:36ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-41702016-01-01010.5935/abc.20160046S0066-782X2016005010101Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection FractionLeandro Rocha MessiasAryanne Guimarães FerreiraSandra Marina Ribeiro de MirandaJosé Antônio Caldas TeixeiraJader Cunha de AzevedoAna Carolina Nader Vasconcelos MessiasElisabeth MarósticaClaudio Tinoco MesquitaAbstract Background: More than 50% of the patients with heart failure have normal ejection fraction (HFNEF). Iodine-123 metaiodobenzylguanidine (123I-MIBG) scintigraphy and cardiopulmonary exercise test (CPET) are prognostic markers in HFNEF. Nebivolol is a beta-blocker with vasodilating properties. Objectives: To evaluate the impact of nebivolol therapy on CPET and123I-MIBG scintigraphic parameters in patients with HFNEF. Methods: Twenty-five patients underwent 123I-MIBG scintigraphy to determine the washout rate and early and late heart-to-mediastinum ratios. During the CPET, we analyzed the systolic blood pressure (SBP) response, heart rate (HR) during effort and recovery (HRR), and oxygen uptake (VO2). After the initial evaluation, we divided our cohort into control and intervention groups. We then started nebivolol and repeated the tests after 3 months. Results: After treatment, the intervention group showed improvement in rest SBP (149 mmHg [143.5-171 mmHg] versus 135 mmHg [125-151 mmHg, p = 0.016]), rest HR (78 bpm [65.5-84 bpm] versus 64.5 bpm [57.5-75.5 bpm, p = 0.028]), peak SBP (235 mmHg [216.5-249 mmHg] versus 198 mmHg [191-220.5 mmHg], p = 0.001), peak HR (124.5 bpm [115-142 bpm] versus 115 bpm [103.7-124 bpm], p= 0.043), HRR on the 1st minute (6.5 bpm [4.75-12.75 bpm] versus 14.5 bpm [6.7-22 bpm], p = 0.025) and HRR on the 2nd minute (15.5 bpm [13-21.75 bpm] versus 23.5 bpm [16-31.7 bpm], p = 0.005), but no change in peak VO2 and 123I-MIBG scintigraphic parameters. Conclusion: Despite a better control in SBP, HR during rest and exercise, and improvement in HRR, nebivolol failed to show a positive effect on peak VO2 and 123I-MIBG scintigraphic parameters. The lack of effect on adrenergic activity may be the cause of the lack of effect on functional capacity.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016005010101&lng=en&tlng=enInsuficiência cardíacateste cardiopulmonar do exercícioMIBGnebivolol |
| spellingShingle | Leandro Rocha Messias Aryanne Guimarães Ferreira Sandra Marina Ribeiro de Miranda José Antônio Caldas Teixeira Jader Cunha de Azevedo Ana Carolina Nader Vasconcelos Messias Elisabeth Maróstica Claudio Tinoco Mesquita Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction Arquivos Brasileiros de Cardiologia Insuficiência cardíaca teste cardiopulmonar do exercício MIBG nebivolol |
| title | Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction |
| title_full | Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction |
| title_fullStr | Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction |
| title_full_unstemmed | Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction |
| title_short | Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction |
| title_sort | effect of nebivolol on mibg parameters and exercise in heart failure with normal ejection fraction |
| topic | Insuficiência cardíaca teste cardiopulmonar do exercício MIBG nebivolol |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016005010101&lng=en&tlng=en |
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