Comparative effects of nebivolol and carvedilol on left ventricular diastolic function in older patients with heart...

Area of Science:

• Cardiology
• Geriatrics
• Pharmacology

Background:

• Limited comparative studies exist for carvedilol and nebivolol in elderly heart failure (HF) patients.
• Nebivolol is suggested to improve diastolic function in older HF patients.
• Elderly HF patients with preserved ejection fraction require specific treatment considerations.

Purpose of the Study:

• To compare the efficacy of nebivolol versus carvedilol in improving left ventricular (LV) diastolic function.
• To evaluate nebivolol's potential superiority in enhancing diastolic function in elderly HF patients (age > 70).
• To assess diastolic function changes in HF patients with preserved LVEF (≥40%) treated with either nebivolol or carvedilol.

Main Methods:

• Prospective, randomized, open-label, single-center, active-controlled study.
• 62 elderly patients (age > 70) with HF (NYHA class II-III) and LVEF ≥40% were randomized.
• Transthoracic echocardiography assessed primary endpoint E/e' at baseline and 12 months.

Main Results:

• No significant differences in baseline characteristics or LV diastolic function indices between carvedilol and nebivolol groups.
• Echocardiography at 12 months showed no significant difference in E/e' or other diastolic parameters between groups.
• Neither group exhibited significant echocardiographic parameter changes over the 12-month follow-up.

Conclusions:

• Carvedilol and nebivolol demonstrated comparable efficacy in improving diastolic function in elderly HF patients with preserved LVEF.
• Nebivolol did not show superiority over carvedilol in this elderly HF population.
• Treatment with either nebivolol or carvedilol did not significantly alter diastolic function parameters in this cohort over 12 months.