[Effects of nebivolol on endothelial dysfunction in patients with diastolic dysfunction of left ventricle]

The aim of our research was to assess the role of vasoactive factors of endothelium (NO and endothelin-1) during diastolic dysfunction of the left ventricle and to determine the effects of nebivolol in the early treatment period of endothelial dysfunction. In the investigation were included 36 male patients (mean age 49+/-6 years) with LVDD due to CAD (22 patients) and essential hypertension (14 patients) as well as in 18 male patients (control group, 12 patients with CAD and 6 with hypertension) without LVDD of matched age, who underwent 2 week treatment with 5 mg nebivolol (Nebilet, Berlin-Chime) . The endothelial dysfunction was assessed by (a) a noninvasive method, brachial artery ultrasound during reactive hyperemia, measured by flow-mediated vasodilatation (FMD), which indirectly reflects the amount of NO and (b) measurement of the amount of ET-1 in the plasma by method of an enzyme-linked immunoassay (ELISA). According to the results of our studies FMD (%) was increased by 73% among the patients with DD of LV whereas among the patients without DD was increased by 66% (p<0,05). Furthermore, statistically none significant decrease of endothelin-1 levels were observed and no difference was found among the groups of patients. Importantly, statistically significant increase of early ventricular filling was found: E/A ratio with Doppler echocardiography at the end of 2 week period treatment reached 1,10+/-0,04 vs. 0,92+/-0,01 before the treatment (p<0,05). Positive correlation was found between FMD (%) and the relaxation capability of the left ventricle (r=0,38, p<0,05). Based on these results we can conclude that endothelial dysfunction might be indicator of LVDD, and by treating the former we can prevent the diastolic dysfunction.