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Effects of β-adrenoblockers on myocardial remodeling, immuno-inflammatory reactions and endothelial dysfunction in patients with ischemic heart disease and chronic heart failure

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Author(s): A.N. Zakirova | N.E. Zakirova | I.M. Karamova | N.Kh. Khafizov | O.V. Rasskazova

Journal: Racionalʹnaâ Farmakoterapiâ v Kardiologii
ISSN 1819-6446

Volume: 3;
Issue: 4;
Start page: 19;
Date: 2007;
Original page

Keywords: chronic heart failure | carvedilol | immuno-inflammatory reactions | endothelial disfunction

ABSTRACT
Aim. To assess the effect of β-adrenoblockers (BAB) on myocardial remodeling, immuno-inflammatory reactions and endothelial dysfunction in patients with ischemic heart disease and chronic heart failure (CHF).Material and methods. 84 patients with ischemic CHF of II-IV functional class were involved in the study. They were randomized in two groups. The first group was presented with 43 patients receiving carvedilol in addition to standard therapy for 24 weeks; the second group was presented with 41 patients receiving metoprolol. Echocardiography, 6-minute walk test were applied. Blood levels of primary and secondary lipid peroxidation (LP) products, cytokines, endothelin-1 (ET-1), intercellular adhesive molecule (VCAM-1) were determined.Results. Both of BAB improved the clinical condition and physical working ability of patients with CHF. Carvedilol in comparison with metoprolol was more effective in myocardial remodeling prevention, inhibition of pro-inflammatory cytokines [tumor necrosis factor alpha (TNF-á), interleukins (IL-1â IL-6)] and LP. Besides carvedilol increased in endothelium-dependent vasodilatation and reduced in ET-1 and VCAM-1 levels.Conclusion. Long-term carvedilol treatment has anti-inflammatory, antioxidant and endothelium-protective effects as well as improves haemodynamics.
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