CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOL

Aim. To compare effects of long term therapy with сarvedilol and bisoprolol on heart and renal functions, heart rate variability (HRV) and quality of life in elderly patients with chronic heart failure (CHF).Material and methods. We examined 40 patients aged 60-75 years on the 15-30 day after myocar...

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Main Authors: M. A. Statsenko, I. A. Sporova, S. V. Belenkova, N. N. Shilina
Format: Article
Language:English
Published: Столичная издательская компания 2015-12-01
Series:Рациональная фармакотерапия в кардиологии
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Online Access:https://www.rpcardio.online/jour/article/view/363
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author M. A. Statsenko
I. A. Sporova
S. V. Belenkova
N. N. Shilina
author_facet M. A. Statsenko
I. A. Sporova
S. V. Belenkova
N. N. Shilina
author_sort M. A. Statsenko
collection DOAJ
description Aim. To compare effects of long term therapy with сarvedilol and bisoprolol on heart and renal functions, heart rate variability (HRV) and quality of life in elderly patients with chronic heart failure (CHF).Material and methods. We examined 40 patients aged 60-75 years on the 15-30 day after myocardial infarction complicated with CHF. All the patients taking basic therapy with enalapril, aspirin, simvastatin and diuretics were randomized to either bisoprolol (n=20) or сarvedilol (n=20) therapy group. The average daily doses were 5,7+0,8 mg for and 32,6+3,4 mg for carvedilol. The duration of the observation period was 12 months. Cardiac morphofunctional parameters, HRV, renal function and quality of life were determined at baseline, after 12 weeks and at the end of the study.Results. Complex therapy of CHF including both beta-blockers resulted in clinical improvement, increase in myocardial contractility. However, carvedilol group showed more pronounced increase in ejection fraction in comparison with bisoprolol group, 8,97% and 5,14%, respectively. Local contractility index decreased significantly only in carvedilol group by 29,9% (p<0,05). Carvedilol demonstrated more significant nephroprotective effects: glomerular filtration rate increased by 32,2%, renal functional reserve restored in 70% of patients. Tubular reabsorbtion, sodium clearance and excretion also increased in carvedilol group. After 12 month of treatment microalbuminuria reduced in both groups of patients, but more significant in carvedilol group. Carvedilol provided more strong blocking effect on sympathetic part of autonomic nervous system according to HRV data.Conclusion. In elderly patients with CHF long term therapy with both carvedilol and bisoprolol provided with improvement in clinical conditions and renal function, increased in HRV and was well tolerated. However, carvedilol compared with bisoprolol showed more significant beneficial effects on cardiac morphofunctional parameters and myocardium contractility. It had priority in reduction of myocardial sympathetic overactivity and nephroprotective action. This effect can be clinically valuable in complex long term therapy of elderly patients with CHF and renal dysfunction.
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spelling doaj-art-074bceec4396426da2a67aaad605b6a42025-08-23T10:00:19ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532015-12-0113111610.20996/1819-6446-2005-1-3-11-16363CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOLM. A. Statsenko0I. A. Sporova1S. V. Belenkova2N. N. Shilina3Volgograd state medical university, City hospital N 3, VolgogradVolgograd state medical university, City hospital N 3, VolgogradVolgograd state medical university, City hospital N 3, VolgogradVolgograd state medical university, City hospital N 3, VolgogradAim. To compare effects of long term therapy with сarvedilol and bisoprolol on heart and renal functions, heart rate variability (HRV) and quality of life in elderly patients with chronic heart failure (CHF).Material and methods. We examined 40 patients aged 60-75 years on the 15-30 day after myocardial infarction complicated with CHF. All the patients taking basic therapy with enalapril, aspirin, simvastatin and diuretics were randomized to either bisoprolol (n=20) or сarvedilol (n=20) therapy group. The average daily doses were 5,7+0,8 mg for and 32,6+3,4 mg for carvedilol. The duration of the observation period was 12 months. Cardiac morphofunctional parameters, HRV, renal function and quality of life were determined at baseline, after 12 weeks and at the end of the study.Results. Complex therapy of CHF including both beta-blockers resulted in clinical improvement, increase in myocardial contractility. However, carvedilol group showed more pronounced increase in ejection fraction in comparison with bisoprolol group, 8,97% and 5,14%, respectively. Local contractility index decreased significantly only in carvedilol group by 29,9% (p<0,05). Carvedilol demonstrated more significant nephroprotective effects: glomerular filtration rate increased by 32,2%, renal functional reserve restored in 70% of patients. Tubular reabsorbtion, sodium clearance and excretion also increased in carvedilol group. After 12 month of treatment microalbuminuria reduced in both groups of patients, but more significant in carvedilol group. Carvedilol provided more strong blocking effect on sympathetic part of autonomic nervous system according to HRV data.Conclusion. In elderly patients with CHF long term therapy with both carvedilol and bisoprolol provided with improvement in clinical conditions and renal function, increased in HRV and was well tolerated. However, carvedilol compared with bisoprolol showed more significant beneficial effects on cardiac morphofunctional parameters and myocardium contractility. It had priority in reduction of myocardial sympathetic overactivity and nephroprotective action. This effect can be clinically valuable in complex long term therapy of elderly patients with CHF and renal dysfunction.https://www.rpcardio.online/jour/article/view/363chronic heart failureсarvedilolbisoprololquality of lifeleft ventricular functionmicroalbuminuriaheart rate variability
spellingShingle M. A. Statsenko
I. A. Sporova
S. V. Belenkova
N. N. Shilina
CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOL
Рациональная фармакотерапия в кардиологии
chronic heart failure
сarvedilol
bisoprolol
quality of life
left ventricular function
microalbuminuria
heart rate variability
title CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOL
title_full CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOL
title_fullStr CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOL
title_full_unstemmed CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOL
title_short CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOL
title_sort cardiorenal relations and quality of life in elderly patients with chronic heart failure in long term therapy with carvedilol and bisoprolol
topic chronic heart failure
сarvedilol
bisoprolol
quality of life
left ventricular function
microalbuminuria
heart rate variability
url https://www.rpcardio.online/jour/article/view/363
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AT iasporova cardiorenalrelationsandqualityoflifeinelderlypatientswithchronicheartfailureinlongtermtherapywithcarvedilolandbisoprolol
AT svbelenkova cardiorenalrelationsandqualityoflifeinelderlypatientswithchronicheartfailureinlongtermtherapywithcarvedilolandbisoprolol
AT nnshilina cardiorenalrelationsandqualityoflifeinelderlypatientswithchronicheartfailureinlongtermtherapywithcarvedilolandbisoprolol