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Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction

Leandro Rocha Messias1, Aryanne Guimarães Ferreira1, Sandra Marina Ribeiro de Miranda1

  • 1Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil.

Arquivos Brasileiros De Cardiologia
|April 21, 2016
PubMed

Insights

Nebivolol improved blood pressure and heart rate recovery in heart failure with normal ejection fraction (HFNEF) patients. However, it did not enhance exercise capacity or adrenergic function, as assessed by cardiopulmonary exercise testing and 123I-MIBG scintigraphy.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Exercise Physiology

Background:

  • Heart failure with normal ejection fraction (HFNEF) affects over 50% of heart failure patients.
  • 123I-MIBG scintigraphy and CPET are established prognostic tools for HFNEF.
  • Nebivolol, a beta-blocker, offers vasodilating properties.

Purpose of the Study:

  • To assess nebivolol's impact on CPET and 123I-MIBG parameters in HFNEF patients.
  • To determine if nebivolol improves functional capacity and adrenergic function in HFNEF.

Main Methods:

  • Twenty-five HFNEF patients underwent baseline 123I-MIBG scintigraphy and CPET.
  • Key CPET metrics included systolic blood pressure (SBP) response, heart rate (HR), heart rate recovery (HRR), and oxygen uptake (VO2).
  • Patients received nebivolol for 3 months, followed by repeat testing.

Main Results:

  • Nebivolol significantly improved rest and peak SBP and HR.
  • Significant improvements were observed in HRR at 1 and 2 minutes post-exercise.
  • No significant changes were noted in peak VO2 or 123I-MIBG scintigraphic parameters (washout rate, heart-to-mediastinum ratios).

Conclusions:

  • Nebivolol effectively controlled SBP and HR and improved HRR in HFNEF patients.
  • Nebivolol did not improve functional capacity (peak VO2) or markers of adrenergic activity (123I-MIBG).
  • The lack of improvement in adrenergic function may explain the absence of enhanced functional capacity.
Abstract

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