Beneficial effects of beta-blockers on left ventricular function and cellular energy reserve in patients with heart failure

Roberto Spoladore, Gabriele Fragasso, Gianluca Perseghin, Francesco De Cobelli, Antonio Esposito, Francesco Maranta, Giliola Calori, Massimo Locatelli, Guido Lattuada, Paola Scifo, Alessandro Del Maschio, Alberto Margonato

Research output: Contribution to journalArticle

Abstract

Beta-blockers have been shown to improve left ventricular (LV) function in patients with heart failure. The aim of this study is to non-invasively assess, by means of in vivo 31P-magnetic resonance spectroscopy (31P-MRS), the effects of beta-blockers on LV cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart failure. Ten heart failure patients on full medical therapy were beta-blocked by either carvedilol or bisoprolol. Before and after 3months of treatment, exercise testing, 2D echocardiography, MRS, New York Heart Association (NYHA) class, ejection fraction (EF), maximal rate-pressure product and exercise metabolic equivalent system (METS) were evaluated. Relative concentrations of PCr and ATP were determined by cardiac 31P-MRS. After beta-blockade, NYHA class decreased (from 2.2±0.54 to 1.9±0.52, P=0.05), whereas EF (from 33±7 to 44±6%, P=0.0009) and METS (from 6.74±2.12 to 8.03±2.39, P=0.01) increased. Accordingly, the mean cardiac PCr/ATP ratio increased by 33% (from 1.48±0.22 to 1.81±0.48, P=0.03). Beta-blockade-induced symptomatic and functional improvement in patients with heart failure is associated to increased PCr/ATP ratio, indicating preservation of myocardial high-energy phosphate levels.

Original languageEnglish
Pages (from-to)455-464
Number of pages10
JournalFundamental and Clinical Pharmacology
Volume27
Issue number4
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Beta-blocker
  • Heart failure
  • Left ventricular ejection fraction
  • Magnetic resonance spectroscopy

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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