Key result
Beta-blocker therapy for 3 months in heart failure patients increased the mean cardiac PCr/ATP ratio from 1.48 to 1.81 (P=0.03), alongside improvements in ejection fraction and NYHA class.
Why the study?
Does beta-blocker therapy improve left ventricular function and cellular energy reserve (PCr/ATP ratio) in patients with heart failure?
Observational (n=10)
Does beta-blocker therapy improve left ventricular function and cellular energy reserve (PCr/ATP ratio) in patients with heart failure?
Effect estimate: 33% increase
Absolute Event Rate: 1.81% vs 1.48%
p-value: p=0.03
Beta-blocker therapy in heart failure patients improves symptomatic and functional status while preserving myocardial high-energy phosphate levels, as evidenced by an increased PCr/ATP ratio.
Beta-blockers have been shown to improve left ventricular (LV) function in patients with heart failure. The aim of this study is to non-invasively assess, by means of in vivo 31P-magnetic resonance spectroscopy (31P-MRS), the effects of beta-blockers on LV cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart failure. Ten heart failure patients on full medical therapy were beta-blocked by either carvedilol or bisoprolol. Before and after 3 months of treatment, exercise testing, 2D echocardiography, MRS, New York Heart Association (NYHA) class, ejection fraction (EF), maximal rate-pressure product and exercise metabolic equivalent system (METS) were evaluated. Relative concentrations of PCr and ATP were determined by cardiac 31P-MRS. After beta-blockade, NYHA class decreased (from 2.2 ± 0.54 to 1.9 ± 0.52, P = 0.05), whereas EF (from 33 ± 7 to 44 ± 6%, P = 0.0009) and METS (from 6.74 ± 2.12 to 8.03 ± 2.39, P = 0.01) increased. Accordingly, the mean cardiac PCr/ATP ratio increased by 33% (from 1.48 ± 0.22 to 1.81 ± 0.48, P = 0.03). Beta-blockade-induced symptomatic and functional improvement in patients with heart failure is associated to increased PCr/ATP ratio, indicating preservation of myocardial high-energy phosphate levels.
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Spoladore et al. (2012) conducted an observational in Heart failure (n=10). Beta-blockers (carvedilol or bisoprolol) vs. Baseline (before treatment) was evaluated on Left ventricular cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio (33% increase, p=0.03). Beta-blocker therapy for 3 months in heart failure patients increased the mean cardiac PCr/ATP ratio from 1.48 to 1.81 (P=0.03), alongside improvements in ejection fraction and NYHA class.
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