Key result
Nebivolol and sotalol comparably suppressed ventricular arrhythmias, but nebivolol had a more positive impact on regulatory adaptive status and increased exercise tolerance more.
Why the study?
Does nebivolol improve regulatory adaptive status and exercise tolerance compared to sotalol in patients with ventricular arrhythmias and hypertension or coronary heart disease?
RCT (n=60)
randomized
Does nebivolol improve regulatory adaptive status and exercise tolerance compared to sotalol in patients with ventricular arrhythmias and hypertension or coronary heart disease?
In patients with ventricular arrhythmias and hypertension or coronary heart disease, nebivolol provides comparable arrhythmia suppression to sotalol but offers superior improvements in regulatory adaptive status and exercise tolerance.
Nebivolol may be preferred over sotalol in ventricular arrhythmia patients with hypertension or CHD; extends RCT evidence for beta-blocker selection by functional outcomes.
Aim. Compare the effectiveness of nebivolol and sotalol in patients ventricular arrhythmias (VA) given its impact on the regulatory adaptive status (RAS). Material and methods. 60 patients with VA of grade I-IV based on the В.Lown grading system, I-II groups based on J.T. Bigger grading system against the background of essential hypertension and/or coronary heart disease took part in the research, they were randomized into two groups for treatment with nebivolol (6,5 ± 2,1 mg/day) and sotalol (166,7 ± 49,4 mg/day). As part of combination therapy, patients were administered lisinopril (13,7 ± 4,5 mg/day and 14,0 ± 4,6 mg/day), acetylsalicylic acid when required (92,9 ± 18,2 mg/day and 95,5 ± 15,1 mg/day), atorvastatin (16,5 ± 4,7 mg/day and 15,7 ± 5,1 mg/day) in addition to nebivolol and sotalol, respectively. Initially and 6 months after therapy, the following was done: quantitative assessment of RAS (by cardio-respiratory synchronism test), echocardiography, triplex scanning of common carotid arteries, treadmill test, six-minute walk test, all-day monitoring of blood pressure and electrocardiogram, subjective assessment of quality of life. Results. Both drug regimens comparably improved structural and functional condition of the heart, increased controlled arterial hypertension, effectively suppressed ventricular arrhythmia, improved the quality of life. Nebivolol positively affected the RAS and increased exercise tolerance more. Conclusion. In patients with VA against the background of essential hypertension and/or coronary heart disease as part of combination therapy the use of nebivolol may be preferable to sotalol due to its positive impact on the RAS.
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Трегубов et al. (2018) conducted an RCT in Ventricular arrhythmias (n=60). Nebivolol vs. Sotalol (166.7 ± 49.4 mg/day) was evaluated on Regulatory adaptive status (RAS) and exercise tolerance. Nebivolol and sotalol comparably suppressed ventricular arrhythmias, but nebivolol had a more positive impact on regulatory adaptive status and increased exercise tolerance more.
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