Comparison of the effects of carvedilol and nebivolol on diastolic functions of the left ventricle in patients with non-ischemic heart failure

61 patients with non-ischemic heart failure with LV ejection fraction ≤40% in previous 3 months and moderate or severe symptomatic HF (NYHA class II to III), mean age ~60-61 years, 35 male. Excluded: significant coronary stenosis, history of myocardial infarction, moderate or severe valvular heart disease, rest heart rate < 60 bpm, systolic blood pressure < 100 mm Hg, history of asthma or use of bronchodilators, hypo- or hyperthyroidism, hepatic or renal failure, rhythm disturbances including second or third degree heart block, sick sinus syndrome, atrial fibrillation, and complete bundle branch block.

Carvedilol started at 3.125 mg twice daily and up-titrated to target dose of 25 mg twice a day (or maximum tolerable dose) added to standard heart failure therapy (ACEI/ARB and diuretics) for 6 months.

Nebivolol started at 1.25 mg once a day and up-titrated to target dose of 10 mg once a day (or maximum tolerable dose) added to standard heart failure therapy (ACEI/ARB and diuretics) for 6 months.

Echocardiographic parameters of left ventricular diastolic function (mitral inflow velocities E and A waves, deceleration time of E wave [DT], isovolumetric relaxation time [IVRT], mitral annular velocities Ea and Aa waves, E/A and E/Ea ratios) at 3 and 6 months.surrogate