alexa Reversal of subclinical left ventricular dysfunction by antihypertensive treatment: a prospective trial of nebivolol against metoprolol.


Journal of Hypertension: Open Access

Author(s): Vinereanu D, Gherghinescu C, Ciobanu AO, Magda S, Niculescu N,

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Abstract OBJECTIVES: To assess the effects of antihypertensive treatment on subclinical left ventricular dysfunction and to compare the effects of nebivolol with metoprolol. METHODS: This is a prospective, randomized, parallel, active-controlled, PROBE design study ( NCT00942487) in 60 patients (53±9 years, 67\% men) with arterial hypertension, left ventricular hypertrophy, normal ejection fraction, and no coronary heart disease, randomized to either a nebivolol-based or a metoprolol-based treatment, who had conventional and tissue Doppler echocardiography, at rest and during dobutamine stress, at baseline and after 6 months. RESULTS: SBP and DBP, and resting heart rate decreased by 13, 13, and 12\%, respectively, on nebivolol, and by 11, 13, and 7\%, respectively, on metoprolol (all, P<0.01). Mean longitudinal early diastolic velocity increased by 16\% (P<0.05) on nebivolol compared with 9\% (P=not significant) on metoprolol (P=not significant for intergroup differences), whereas flow propagation velocity increased by 34\% on nebivolol (P<0.05) and did not change on metoprolol (P<0.01 for intergroup differences). Mean longitudinal displacement increased by 10\% on nebivolol (P<0.05) and did not change on metoprolol (P<0.05 for intergroup differences), whereas ejection time increased by 5\% on nebivolol (P<0.05) and did not change on metoprolol. All the other parameters of left ventricular function were not different between the two treatment arms. CONCLUSION: Patients with mild-to-moderate hypertension have a beneficial effect from 6-month antihypertensive treatment on diastolic longitudinal left ventricular function; effects are significant with nebivolol, but not with metoprolol. This article was published in J Hypertens and referenced in Journal of Hypertension: Open Access

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